MO578OSTEOCALCIN AND VASCULAR CALCIFICATION IN HEMODIALYSIS PATIENTS: AN OBSERVATIONAL COHORT STUDY

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Hesham Kamal Habeeb Keryakos ◽  
Ahmed Salama ◽  
Nagwa Okaily ◽  
Mariam Boulis
Keyword(s):  
Vascular Calcification ◽  
Strong Predictor ◽  
Serum Vitamin ◽  
Hemodialysis Patients ◽  
Vitamin K2 ◽  
Maintenance Hemodialysis ◽  
Undercarboxylated Osteocalcin ◽  
Median Serum ◽  
K Deficiency ◽  
Observational Cohort

Abstract Background and Aims Vascular calcification contributes to morbidity and mortality in patients with ESRD on maintenance hemodialysis. to study the relationship between osteocalcin and vascular calcification. Method 160 patients with ESRD on maintenance hemodialysis and 60 age-and sex-matched healthy controls were recruited. Serum vitamin K2 and osteocalcin both intact and undercarboxylated were measured. Transthoracic echocardiography was done for valvular calcification and thickening, and carotid duplex was done for carotid intimal medial calcification and thickening. Results Hemodialysis patients have higher median serum vitamin K2 (p<0.001), higher undercarboxylated osteocalcin (p<0.001). Only older age, duration of hypertension, and duration of established cardiovascular disease are associated with carotid media-intimal calcification. Old age is a strong predictor of carotid media intimal thickening. Female sex is associated with valvular thickening. Conclusion Functional vitamin K deficiency is present in maintenance hemodialysis patients and serum osteocalcin is not associated with cardiovascular calcification.

Hypervitaminosis B12 in Maintenance Hemodialysis Patients Receiving Massive Supplementation of Vitamin B12

1986 ◽  
Vol 9 (6) ◽  
pp. 417-420 ◽  
Author(s):  
G. Mangiarotti ◽  
C. Canavese ◽  
M. Salomone ◽  
A. Thea ◽  
A. Pacitti ◽  
...  
Keyword(s):  
Vitamin B12 ◽  
Motor Nerve ◽  
Serum Vitamin ◽  
Hemodialysis Patients ◽  
Epidemiologic Studies ◽  
Motor Nerve Conduction Velocity ◽  
Maintenance Hemodialysis ◽  
Motor Nerve Conduction ◽  
High Level ◽  
Very High

We have administered routinely a multivitamin preparation containing a megadose of B12 to 106 hemodialysis patients after dialysis treatments. We found that these patients had very high levels of serum vitamin B12 which returned to original values only after a period of three years after stopping the vitamin. Discontinuing therapy had no effect on hemoglobin, mean erythrocyte corpuscular volume, or motor nerve conduction velocity. It is not known whether maintaining a prolonged high level of vitamin B12 is harmful. However, animal and epidemiologic studies have suggested that both cobalamin and cobalt may be potentially toxic. In view of the absence of demonstrable benefit and the possible risk of toxicity, we believe that the use of such megadose vitamin compounds in dialysis patients should be re-evaluated.

Vascular Calcification in Maintenance Hemodialysis Patients

2009 ◽  
Vol 28 (1) ◽  
pp. 15-20 ◽  
Author(s):  
Mi Wang ◽  
Mei Wang ◽  
Liang-Ying Gan ◽  
Si-Jun Li ◽  
Nan Hong ◽  
...  
Keyword(s):  
Vascular Calcification ◽  
Hemodialysis Patients ◽  
Maintenance Hemodialysis ◽  
Maintenance Hemodialysis Patients

scholarly journals Quantitative Sonographic Assessment of Quadriceps Muscle Thickness for Prospective Fall Injury in Patients Undergoing Maintenance Hemodialysis: an Observational Cohort Study

2020 ◽  
Author(s):  
Asuka Sai ◽  
Kentaro Tanaka ◽  
Yasushi Ohashi ◽  
Akifumi Kushiyama ◽  
Yoshihide Tanaka ◽  
...  
Keyword(s):  
Cohort Study ◽  
Handgrip Strength ◽  
Muscle Thickness ◽  
Quadriceps Muscle ◽  
Hemodialysis Patients ◽  
Observational Cohort Study ◽  
Maintenance Hemodialysis ◽  
Thigh Circumference ◽  
Fall Injury ◽  
Observational Cohort

Abstract Introduction: Accidental fall risk is high in patients undergoing maintenance hemodialysis. Falls are associated with fatal injury, comorbidities, and mortality. Risk assessment should be conducted as a primary intervention to prevent falls. This study investigated whether quadriceps muscle thickness measured using ultrasonography can prospectively predict fall injury among dialysis patients.Methods: Using an observational cohort study design, 180 ambulatory hemodialysis patients during the period 2015–2016 were recruited in the four dialysis clinics. The sum of the maximum quadriceps muscle thickness on both sides and the average of the maximum thigh circumference and handgrip strength after hemodialysis were calculated. Patients were stratified according to tertiles of quadriceps muscle thickness. Fall injury was surveyed according to the patient’s self-report for the one-year period.Results: Among the 180 hemodialysis patients, 42 (23.3%) had fall injury during the 12-month follow-up period. When the quadriceps muscle thickness levels were stratified into sex-specific tertile, patients in the lowest tertile (men <3.66 cm and women <3.50 cm) were more likely to have higher incidence of fall injury compared with those in the higher two tertiles (0.56 vs. 0.18 and 0.15 fall injuries/person-year). After adjusting for covariates, lower quadriceps muscle thickness was found to be an independent predictor for fall injury (hazard ratio [95% confidence interval], 2.99 [1.46–6.32], P < 0.001). Conversely, no significant differences were found in the thigh circumference and handgrip strength between women with fall injury and those women without fall injury.Conclusions: Quadriceps muscle thickness using ultrasonography can be measured easily at the bedside and is a precise predictor of fall injury in patients undergoing maintenance hemodialysis.

Maximal dose-response of vitamin-K2 (menaquinone-4) on undercarboxylated osteocalcin in women with osteoporosis

2020 ◽  
Vol 90 (1-2) ◽  
pp. 42-48 ◽  
Author(s):  
Tusar K Giri ◽  
David Newton ◽  
Opal Chaudhary ◽  
Elena Deych ◽  
Nicola Napoli ◽  
...  
Keyword(s):  
Postmenopausal Women ◽  
Dose Response ◽  
Geometric Mean ◽  
Serum Vitamin ◽  
Osteoporotic Fractures ◽  
Vitamin K2 ◽  
Vertebral Compression Fractures ◽  
High Dose ◽  
Undercarboxylated Osteocalcin ◽  
High Concentrations

Abstract. Low concentrations of serum vitamin K accompany high concentrations of undercarboxylated osteocalcin (ucOC) and osteoporotic fractures. Although vitamin K2 (MK-4) is approved as a therapeutic agent for the treatment of osteoporosis in some countries, the dose-response is unknown. The objective of this study was to assess the improvement in carboxylation of osteocalcin (OC) in response to escalating doses of MK-4 supplementation. A nine-week, open-labeled, prospective cohort study was conducted in 29 postmenopausal women who suffered hip or vertebral compression fractures. Participants took low-dose MK-4 (0.5 mg) for 3 weeks (until the second visit), then medium-dose MK-4 (5 mg) for 3 weeks (until the third visit), then high-dose MK-4 (45 mg) for 3 weeks. The mean ±  SD age of the participants was 69 ± 9 years. MK-4 dose (p < 0.0001), but neither age nor other relevant medications (e.g. bisphosphonates) correlated with improvement in %ucOC. As compared to baseline concentrations (geometric mean ±  SD) of 16.8 ± 2.4, 0.5 mg supplementation halved %ucOC to 8.7 ± 2.2 (p < 0.0001) and the 5-mg dose halved %ucOC again (to 3.9 ± 2.2; p = 0.0002 compared to 0.5-mg dose). However, compared to 5 mg/day, there was no additional benefit of 45 mg/day (%ucOC 4.6; p = NS vs. 5-mg dose). MK-4 supplementation resulted in borderline increases in γ-carboxylated osteocalcin (glaOC; p = 0.07). There were no major side effects of MK-4 supplementation. In postmenopausal women with osteoporotic fractures, supplementation with either 5 or 45 mg/day of MK-4 reduces ucOC to concentrations typical of healthy, pre-menopausal women.

scholarly journals Slower Progression of Arteriosclerosis in Maintenance Hemodialysis Patients with Menaquinone Supplementation: A Perspective Randomized, Placebo-Controlled Trial

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 78-78
Author(s):  
Jing Tan ◽  
Dan Xu ◽  
Anxiu Yang ◽  
Ruijun Ren
Keyword(s):  
Controlled Trial ◽  
Hemodialysis Patients ◽  
Vitamin K2 ◽  
Matrix Gla Protein ◽  
Maintenance Hemodialysis ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Clinical Trial Registry ◽  
Significant Difference ◽  
Maintenance Hemodialysis Patients

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.

Vascular calcification by conventional X-ray and mortality in a cohort of predominantly African descent hemodialysis patients

2020 ◽  
pp. 039139882096280
Author(s):  
Maria Tereza S Martins ◽  
Cácia M Matos ◽  
Marcelo B Lopes ◽  
Angiolina C Kraychete ◽  
Gildete B Lopes ◽  
...  
Keyword(s):  
Vascular Calcification ◽  
African Descent ◽  
Conventional Radiography ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
Maintenance Hemodialysis ◽  
Prediction Tool ◽  
X Ray ◽  
Cox's Regression ◽  
Vascular Beds

Background/objective: There is a lack of studies describing the prevalence of vascular calcification (VC) and its association with mortality in maintenance hemodialysis (MHD) patients of African descent. We investigated if a VC score based on the number of calcified vascular beds was associated with mortality in MHD patients. Methods: We analyzed data from 211 MHD patients enrolled from January 2010 to January 2011 in the prospective cohort study, “The Prospective Study of the Prognosis of Chronic Hemodialysis Patients (PROHEMO),” developed in Salvador, BA, Brazil. VC was evaluated using radiographs of the hands, abdomen, hip, and chest; the score was calculated by the number of calcified sites as 0 (absence of calcification), 1 (one calcified site), 2 (two sites), 3 (⩾3 sites). We used Cox’s regression to estimate the hazard ratio (HR) and 95% confidence interval (CI) of associations between VC and mortality with adjustments for age and comorbidities. Results: VC was detected in 114 (54.0%) patients; 37 (17.5%) with a VC score = 1; 21 (10%) with VC score = 2 and 56 (26.5%) with VC score = 3. Compared with VC score = 0, the adjusted hazard of death was 2.67 (95% CI: 1.12, 6.33) for patients with VC score = 1; HR = 2.89 (95% CI: 0.95, 7.63) for VC score = 2; and HR = 3.27 (95% CI: 1.47, 7.28) for VC score = 3. Conclusion: The present study in an African descent MHD population provides support for the VC score based on conventional radiography as a prediction tool for the clinical practice. As shown, the VC score was monotonically and independently associated with mortality.

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