Abstract: FR-PO832

Plasma Total Matrix Gla Protein, Vitamin K Levels, and Vascular Calcification in Prevalent Hemodialysis Patients

Session Information

Category: Dialysis

  • 601 Standard Hemodialysis for ESRD

Authors

  • Mizuiri, Sonoo, Ichiyokai Harada Hospital, Hiroshima, Japan
  • Nishizawa, Yoshiko, Ichiyokai Harada Hospital, Hiroshima, Japan
  • Yamashita, Kazuomi, Ichiyokai Harada Hospital, Hiroshima, Japan
  • Usui, Kohji, Ichiyokai Ichiyokai Clinic, Hiroshima, Japan
  • Tanji, Chie, Ichiyokai Ichiyokai Clinic, Hiroshima, Japan
  • Doi, Shigehiro, Hiroshima University Hospital, Hiroshima, Japan
  • Masaki, Takao, Hiroshima University Hospital, Hiroshima, Japan
  • Shigemoto, Kenichiro, Ichiyokai Harada Hospital, Hiroshima, Japan
Background

Hemodialysis (HD) patients suffer from accelerated vascular calcification. Vitamin K-dependent matrix Gla protein (MGP) is a potent inhibitor of vascular calcification but published data on plasma MGP levels of HD patients are inconsistent. This study investigated the associations between the plasma total MGP level and the vitamin K level or vascular calcification in HD patients.

Methods

Subjects were 73 prevalent HD patients aged≤60 years and 40 healthy controls. Plasma total (including inactive) MGP levels were assessed using an ELISA kit (Cloud-Clone Corp). Predictors of the plasma MGP level in patients were identified by regression analyses [variables: age, presence of diabetes, presence of cardiovascular disease, dialysis vintage, Agatston (coronary artery calcification) score, serum phosphate, calcium, intact parathyroid hormone, vitamin K1, and vitamin K2 levels, Kt/Vurea, and geriatric nutritional risk index (GNRI)]. The variables that displayed significance in the univariate analyses were subjected to multiple regression analysis.

Results

The healthy subjects’ mean estimated glomerular filtration rate was 78±13 ml/min/1.73m2. The HD patients’ (including 25 patients with diabetes) median dialysis vintage was 78 (36-152) months. The age (50±6 vs.48±6 years), sex distribution, and body mass index and vitamin K2 levels were not significantly different, but the vitamin K1 levels were significantly lower (0.56±0.37 vs. 0.98±0.61 ng/ml, P<0.0001), and the MGP levels were significantly higher (290±50 vs.160±41 ng/ml, P<0.0001) in HD patients as compared to controls. Regression analyses indicated that age, dialysis vintage, presence of cardiovascular disease, vitamin K1 level, and GNRI were significantly associated with the MGP level [β (95% CI): 0.35 (2.11-6.52), P<0.001, 0.25 (0.01-0.23), P<0.05, 0.28 (2.79-27.15), P<0.05, -0.28 (-70.01--14.56), P<0.05, -0.25 (-4.36--0.18), P<0.05, respectively]. In the multiple regression analysis, only presence of cardiovascular disease was found to be significantly associated with the MGP level [β (95% CI): 0.24 (0.58-24.77), P<0.05].

Conclusion

HD patients had lower vitamin K1 levels than healthy subjects, and the plasma total MGP level is significantly associated with cardiovascular disease, but not the Agatston score, in HD patients.

Funding

  • Private Foundation Support