Abstract
Objectives
To investigate the effects of menaquinone on the progression of arteriosclerosis in maintenance hemodialysis patients, and to provide evidence for the clinical prevention strategy of cardiovascular diseases in maintenance hemodialysis patients.
Methods
In this perspective, randomized, placebo-controlled trial, 107 MHD patients were randomized into Vitamin K2 group (VK2, n = 60) that received vitamin K2(menaquinone) at a dose of 270 μg/d and control group (n = 47). The following measurements were taken at baseline and after 9 months: carotid pulse wave velocity (cPWV) was measured with ultrasound, dephosphorylated-uncarboxylated matrix Gla protein (dp-ucMGP) was tested with enzyme-linked immunosorbent assay.
Results
After 9 months follow-up, 40 patients from the VK2 group and 38 patients from the control group were included in the analysis. The cPWV values of MHD patients was positively correlated with age (r = 0.293, P = 0.01) and hypertension complication (r = 0.495, P = 0.00). The baseline cPWV values of VK2 group and the control group did not show a significant difference (7.53 ± 1.47 vs. 7.28 ± 1.18 m/s, P = 0.24). After 9 months of intervention, cPWV values in VK2 group were lower than baseline, but not significant (7.60 ± 1.50 vs. 7.53 ± 1.47 m/s, P = 0.90). The cPWV values of the control group at 6 months were increased when compared with the baseline (7.21 ± 1.18 vs. 7.86 ± 1.14 m/s, P = 0.04) . The increment rate of cPWV(△cPWV) from VK2 group was significantly lower than the control group (1.32 ± 12.53% vs 10.40 ± 16.85%, P = 0.00) 3. Baseline dp-ucMGP level of VK2 group and the control group showed no significant difference (1802.30 ± 552.88 vs. 1698.15 ± 488.06 nmol/L, P = 0.67) . After 9 months, the dp-ucMGP level in VK2 group was significantly decreased (1802.30 ± 552.88 vs 1448.42 ± 456.08 nmol/L, P = 0.01) , and significantly lower than control group (1448.42 ± 456.08 vs 1705.42 ± 424.48 nmol/L, P = 0.03).
Conclusions
Menaquinone supplementation induced a marked reduction of inactive MGP, and may retard the progression of arteriosclerosis in maintenance hemodialysis patients. This trial was registered at the Chinese Clinical Trial Registry as ChiCTR1900028459.
Funding Sources
None.