Key result
Exposure to vitamin K antagonists in patients receiving dialysis was associated with a significantly increased risk of calciphylaxis (OR 61; 95% CI 6.7-546; p=0.0001).
Why the study?
Do vitamin K antagonists increase the risk of calciphylaxis in patients receiving dialysis?
Cohort (n=2,234)
No
Do vitamin K antagonists increase the risk of calciphylaxis in patients receiving dialysis?
In patients receiving dialysis, treatment with vitamin K antagonists is associated with a markedly increased risk of developing calciphylaxis.
Answers are grounded in this paper and cite their sources.
Supports caution with vitamin K antagonists in dialysis; leaves open confirmation in prospective trials.
BACKGROUND/AIMS: Calciphylaxis is associated with a poor prognosis in dialysis patients, and its pathogenesis remains incompletely understood. Although the use of vitamin K antagonists (VKA) has been implicated, previous reports are conflicting. We aimed to determine if vitamin K antagonists conferred an increased risk of calciphylaxis in patients on dialysis. METHODS: We performed a single-centre, retrospective cohort study of 2,234 patients receiving dialysis, and compared the characteristics of those with and without calciphylaxis. RESULTS: We identified 5 cases of calciphylaxis (all female) between January 2009 and December 2013. Overall, 142 patients (6.4%) were treated with VKA during the study period. Calciphylaxis was more common in the VKA group (4 of 142 patients, OR = 61, 95% CI 6.7-546, p = 0.0001). VKA was withdrawn in all cases and treatment instituted with sodium thiosulphate, cinacalcet and supportive measures. All patients recovered, although there was one sudden cerebrovascular death during follow-up. CONCLUSION: Treatment with VKA predisposes to the development of calciphylaxis.
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Galloway et al. (2015) conducted a cohort in End-Stage Renal Disease (n=2,234). Vitamin K antagonists vs. No vitamin K antagonists was evaluated on Calciphylaxis (OR 61, 95% CI 6.7-546, p=0.0001). Exposure to vitamin K antagonists in patients receiving dialysis was associated with a significantly increased risk of calciphylaxis (OR 61; 95% CI 6.7-546; p=0.0001).
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