MK-7 Improves Progression of Arterial Stiffness in Diabetic Chronic Kidney Disease Patients

by | Jun 19, 2023 | 2023, Diabetes, Kidney Health, Vitamin K

Written by Chrystal Moulton, Staff Writer. Primary outcome showed no significant improvement in CF PWV (P= 0.24). Subgroup analysis showed improvement among diabetic chronic kidney disease patients (P < 0.05).

Individuals with end stage kidney disease are at significant risk for cardiovascular mortality and morbidity1. Research suggests a positive correlation between arterial calcification in patients with chronic hemodialysis and arterial stiffness2. Research also shows that this may be due to subclinical deficiency in vitamin K3. Furthermore, patients with chronic kidney disease on dialysis have a very high prevalence of subclinical vitamin K deficiency4. In the current trial, researchers investigated the efficacy of vitamin K2 supplementation [MK-7] in improving the progression of arterial stiffness in chronic kidney disease patients on hemodialysis compared to control5.

The researchers in this study conducted a multicenter randomized control study. Inclusion criteria were maintenance of hemodialysis twice a week 1 month prior to screening, carotid femoral pulse wave velocity (cfPWV) greater than 10 m/s at screening, and aged 18 years old or more at screening. Patients were randomized in a 1:1 ratio to either the treatment group (oral MK-7 supplement 375 mcg/day once daily for 24 weeks) or control (standard treatment without vitamin K supplement). Carotid femoral pulse wave velocity (cfPWV) was the primary outcome while the number of patients with progression progression of arterial stiffness compared to baseline along with changes in biochemistry was the secondary outcome. All patients maintained hemodialysis throughout the 24 week trial.

A total of 96 patients participated in this trial. Fifty patients were randomly assigned to the treatment group and 46 to the control. Before the end of the trial, 7 patients in the treatment group and 3 in the control group discontinued participation. At week 24, 86 patients completed the trial (treatment group = 43 patients; control group = 43 patients). No significant differences were observed in baseline characteristics between the treatment and control group. Primary outcome measurement showed no significant difference an average cfPWV between treatment and control (P = 0.24). Sensitivity analysis performed on these patients also showed no significant difference in absolute and percent cfPWV change. Subgroup analysis, however, show significant percent change in cfPWV in patients with diabetes (P< 0.05). Patients with diabetes also showed reduce progression of arterial stiffness at week 24 (P= 0.01). Secondary outcome measurements revealed no significant differences between groups. Nine patients experienced adverse events during the trial period (gastrointestinal side effects, COVID infection, cancer, atrial fibrillation, and AVF thrombosis). Overall compliance and tolerance to vitamin K supplementation was good (>95%).

This study showed that 24-week MK- 7 supplementation did not significantly improve arterial stiffness in end stage kidney disease patients. However, subgroup analysis revealed that MK-7 demonstrated improvement in the progression of arterial stiffness among patients with diabetes compared to control. Additional studies will be needed to verify these findings.

Source: Naiyarakseree, Nuanjanthip, Jeerath Phannajit, Wichai Naiyarakseree, Nanta Mahatanan, Pagaporn Asavapujanamanee, Sookruetai Lekhyananda, Supat Vanichakarn et al. “Effect of Menaquinone-7 Supplementation on Arterial Stiffness in Chronic Hemodialysis Patients: A Multicenter Randomized Controlled Trial.” Nutrients 15, no. 11 (2023): 2422.

© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).

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Posted June 19, 2023.

Chrystal Moulton BA, PMP, is a 2008 graduate of the University of Illinois at Chicago. She graduated with a bachelor’s in psychology with a focus on premedical studies and is a licensed project manager. She currently resides in Indianapolis, IN.

References:

  1. Wathanavasin W, Banjongjit A, Avihingsanon Y, et al. Prevalence of Sarcopenia and Its Impact on Cardiovascular Events and Mortality among Dialysis Patients: A Systematic Review and Meta-Analysis. Nutrients. Sep 30 2022;14(19)doi:10.3390/nu14194077
  2. Guérin AP, London GM, Marchais SJ, Metivier F. Arterial stiffening and vascular calcifications in end-stage renal disease. Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association – European Renal Association. Jul 2000;15(7):1014-21. doi:10.1093/ndt/15.7.1014
  3. Shea MK, Booth SL. Vitamin K, Vascular Calcification, and Chronic Kidney Disease: Current Evidence and Unanswered Questions. Current developments in nutrition. Sep 2019;3(9):nzz077. doi:10.1093/cdn/nzz077
  4. McCabe KM, Adams MA, Holden RM. Vitamin K status in chronic kidney disease. Nutrients. Nov 7 2013;5(11):4390-8. doi:10.3390/nu5114390
  5. Naiyarakseree N, Phannajit J, Naiyarakseree W, et al. Effect of Menaquinone-7 Supplementation on Arterial Stiffness in Chronic Hemodialysis Patients: A Multicenter Randomized Controlled Trial. Nutrients. May 23 2023;15(11)doi:10.3390/nu15112422