Vitamin K status and vascular calcification biomarkers as determinants of carotid plaque in peritoneal dialysis: a prospective study
Renal Failure, cilt.48, sa.1, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 48 Sayı: 1
- Basım Tarihi: 2026
- Doi Numarası: 10.1080/0886022x.2026.2691345
- Dergi Adı: Renal Failure
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, EMBASE, MEDLINE, Directory of Open Access Journals, Academic Search Ultimate (EBSCO), Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest)
- Anahtar Kelimeler: carotid plaque, matrix Gla protein, Peritoneal dialysis, PIVKA-II, vascular calcification, vitamin K deficiency
- Gazi Üniversitesi Adresli: Evet
Özet
Background: Vitamin K deficiency impairs the activation of calcification inhibitors such as matrix Gla protein, promoting vascular calcification in CKD. Protein induced by vitamin K absence-II (PIVKA-II) is a filtration-independent marker of vitamin K status validated in hemodialysis, yet no data exist in peritoneal dialysis (PD). Methods: Sixty prevalent PD patients at a single tertiary center were prospectively followed for 1 year. Serum PIVKA-II, dephosphorylated uncarboxylated matrix Gla protein (dp-ucMGP), and bone morphogenetic protein-2 (BMP-2) were measured at baseline and 12 months. Carotid plaque was assessed by ultrasonography. Independent predictors of plaque were identified by multivariable logistic regression and ROC analysis. Results: Carotid plaque was present in 36 patients (60%). Vitamin K deficiency (PIVKA-II >40 mAU/mL) was identified in 43.3% and was more prevalent in plaque-positive patients (55.5% vs 25.0%; p = 0.019). All three biomarkers were significantly elevated in the plaque group. Age (OR 1.26; 95% CI 1.07–1.42; p = 0.004) and PIVKA-II (OR 1.71; 95% CI 1.09–2.70; p = 0.022) independently predicted plaque. The area under the ROC curve was 0.766 (p = 0.001) with an optimal cutoff of 35.09 mAU/mL (sensitivity 86.1%, specificity 50.0%). Over 12 months, plaque prevalence rose to 70%; baseline BMP-2 was the sole predictor of new plaque development (p = 0.022). Conclusion: PIVKA-II–assessed vitamin K deficiency is common in PD and independently associated with carotid plaque. A threshold of 35 mAU/mL may be more sensitive than the conventional 40 mAU/mL cutoff, supporting PIVKA-II screening and targeted supplementation trials in PD.