Key result
PIVKA-II-assessed vitamin K deficiency above ~35 mAU/mL is linked to carotid plaque in peritoneal dialysis patients.
Why the study?
Is vitamin K deficiency (assessed by PIVKA-II) associated with carotid plaque in peritoneal dialysis patients?
Cohort (n=60)
No
Is vitamin K deficiency (assessed by PIVKA-II) associated with carotid plaque in peritoneal dialysis patients?
PIVKA-II-assessed vitamin K deficiency is common in peritoneal dialysis patients and is independently associated with carotid plaque, suggesting a potential role for screening and targeted supplementation.
May support PIVKA-II monitoring of vitamin K status in PD; extends hemodialysis data but leaves open need for RCTs.
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. 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.
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Pamuk et al. (2026) conducted a cohort in Peritoneal dialysis (n=60). Vitamin K status assessment (PIVKA-II) was evaluated on Carotid plaque (p=0.022). PIVKA-II-assessed vitamin K deficiency is independently associated with carotid plaque in peritoneal dialysis patients (P=0.022), with a suggested threshold of 35 mAU/mL.
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