Vitamin K status and mortality after kidney transplantation: a cohort study.

摘要: Background Vitamin K modulates calcification by activating inhibitors such as matrix Gla protein (MGP). In kidney transplant recipients, vitamin insufficiency is common, but implications for long-term outcomes are unclear. Study Design Single-center observational study with a longitudinal design. Setting & Participants 518 stable recipients; 56% men; mean age, 51±12 (SD) years; and median of 6 (IQR, 3-12) years after transplantation. Factor Plasma desphosphorylated-uncarboxylated MGP (dp-ucMGP) levels, reflecting status. Outcomes All-cause mortality failure. Results At inclusion, dp-ucMGP level was 1,038 733-1,536) pmol/L, 473 (91%) patients having (defined dp-ucMGP>500pmol/L). During follow-up 9.8 8.5-10.2) years, 152 (29%) died 54 (10%) developed Patients in the highest quartile were at considerably higher risk compared lowest (HR, 3.10; 95% CI, 1.87-5.12; P trend Limitations Although exists various species, only measured. No data available vascular an intermediate end point. Conclusions insufficiency, that is, high circulating dp-ucMGP, highly prevalent recipients associated independently increased mortality. Future studies should address whether supplementation may lead to improved