Key result
In 132 hemodialysis patients, replacing VKAs with rivaroxaban (with or without vitamin K2) for 18 months did not significantly change vascular calcification progression compared to VKAs.
Why the study?
VKAs are suspected to accelerate vascular calcification in hemodialysis patients, and functional vitamin K deficiency may exacerbate this susceptibility.
Does rivaroxaban with or without vitamin K2 reduce vascular calcification progression compared to VKAs in hemodialysis patients with atrial fibrillation?
RCT (n=132)
Yes
Does rivaroxaban with or without vitamin K2 reduce vascular calcification progression compared to VKAs in hemodialysis patients with atrial fibrillation?
In hemodialysis patients with atrial fibrillation, replacing VKAs with rivaroxaban (with or without vitamin K2) improved vitamin K status but did not halt vascular calcification progression, though it may reduce severe bleeding.
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Vitamin K repletion may improve status in hemodialysis with AF; leaves open effects on calcification or outcomes.
Vriese et al. (2019) conducted an RCT in Hemodialysis with atrial fibrillation (n=132). Rivaroxaban with or without Vitamin K2 vs. Vitamin K antagonists (VKAs) with target INR 2-3 was evaluated on Vascular calcification progression (changes in coronary artery, thoracic aorta, and cardiac valve calcium scores and pulse wave velocity). In 132 hemodialysis patients, replacing VKAs with rivaroxaban (with or without vitamin K2) for 18 months did not significantly change vascular calcification progression compared to VKAs.
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