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The following is a summary of “PIVKA-II but not dp-ucMGP is associated with aortic calcification in chronic kidney disease,” published in the November 2024 issue of Nephrology by Nyvad et al.
Patients with chronic kidney disease (CKD) often experience vascular calcification and vitamin K deficiency. Inactive matrix gla protein (MGP), i.e., dephosphorylated uncarboxylated MGP (dp-ucMGP) and vitamin K absence (PIVKA-II) are elevated in CKD and linked to calcification.
Researchers conducted a retrospective study to assess the utility of dp-ucMGP and PIVKA-II as markers of aortic calcification in CKD.
They performed non-contrast computed tomography scans of the entire aorta on patients with normal or reduced kidney function, followed by blinded standard calcification scoring using the Agatston method. Blood samples were collected and analyzed for plasma concentrations of dp-ucMGP and PIVKA-II.
The results showed that 141 patients (104 with CKD stage 3–5) were included. Median dp-ucMGP was 543 (503–744) pmol/l in CKD and 1,078 (835–1682) pmol/l without CKD (P < 0.01). Median PIVKA-II was 19.3 (16.3–23.5) ng/ml in CKD and 21.8 (17.2–36.8) ng/ml without CKD (P = 0.33). Aortic Agatston scores were 1,644 (729–4138) in CKD and 7,172 (2834–15360) without CKD (P < 0.01). Agatston score showed a positive association with PIVKA-II (β = 0.71, P = 0.014, r2 = 0.04) and a trend with dp-ucMGP (β = 0.44, P = 0.08, r2 = 0.02). Age, estimated glomerular filtration rate (eGFR), and smoking remained associated with Agatston score, with age having a stronger association than PIVKA-II, eGFR, and smoking.
They found that vitamin K deficiency, estimated through PIVKA-II, was weakly associated with aortic Agatston score, while dp-ucMGP showed no significant association. Both markers were outperformed by age, smoking, and eGFR in predicting aortic calcification.
Source: bmcnephrol.biomedcentral.com/articles/10.1186/s12882-024-03876-5
