Vitamin K supplementation for cystic fibrosis

Jagannath, Vanitha A; Fedorowicz, Zbys; Thaker, Vidhu; Chang, Anne B.; Al-Harthy, Nutayla

doi:10.1002/14651858.cd008482

Cited by 4 publications

(3 citation statements)

References 26 publications

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“…Thus, a systematic review on vitamin K supplementation in people with CF could provide evidence to guide clinical practice. This is an update of previous review versions (Jagannath 2010;Jagannath 2011;Jagannath 2013).…”

Section: Why It Is Important To Do This Reviewmentioning

confidence: 97%

Vitamin K supplementation for cystic fibrosis

Jagannath

Fedorowicz²,

Thaker

et al. 2015

Cochrane Database of Systematic Reviews

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Background-Cystic fibrosis is a genetic disorder which can lead to multiorgan dysfunction. Malabsorption of fat and fat-soluble vitamins (A, D, E, K) may occur and can cause subclinical deficiencies of some of these vitamins. Vitamin K is known to play an important role in both blood coagulation and bone formation. Supplementation with vitamin K appears to be one way of addressing the deficiency, but there is very limited agreement on the appropriate dose and frequency of use of these supplements.

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Section: Why It Is Important To Do This Reviewmentioning

confidence: 97%

Vitamin K supplementation for cystic fibrosis

Jagannath

Fedorowicz²,

Thaker

et al. 2015

Cochrane Database of Systematic Reviews

Self Cite

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“…Evidence from randomized controlled trials on vitamin K supplementation for CF patients is currently weak and limited to two small trials (total of 32 participants). Both trials reported normal levels of undercarboxylated osteocalcin after one month of daily supplementation with 1 mg of vitamin K 9 . Siwamogsatham et al found that despite nearly doubling fat-soluble vitamin dosage (including vitamin K) in CF patients with pancreatic insufficiency over a 5 year period, there was no parallel increase in blood concentrations of these vitamins 11 .…”

mentioning

confidence: 96%

“…It has been suggested that the deficiency is a result of fat malabsorption, bowel resection, liver disease, and chronic antibiotic treatment 8 . The manifestation of vitamin K deficiency may include bleeding (via the nose, gastrointestinal system, and urine), bruising, and osteoporosis 9 .…”

mentioning

confidence: 99%

Exogenous and endogenous determinants of vitamin K status in cystic fibrosis

Krzyżanowska

Pogorzelski²,

Skorupa³

et al. 2015

Sci Rep

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Cystic fibrosis (CF) patients are at high risk for vitamin K deficiency. The effects of vitamin K supplementation are very ambiguous. Therefore, we aimed to define the determinants of vitamin K deficiency in a large cohort of supplemented - 146 (86.9%) and non-supplemented - 22 (13.1%) CF patients. Vitamin K status was assessed using prothrombin inducted by vitamin K absence (PIVKA-II) and undercarboxylated osteocalcin (u-OC). The pathological PIVKA-II concentration (≥2 ng/ml) and abnormal percentage of osteocalcin (≥20%) were found in 72 (42.8%) and 60 (35.7%) subjects, respectively. We found that liver involvement, diabetes, and glucocorticoid therapy were potential risk factors for vitamin K deficiency. Pathological concentrations of PIVKA-II occurred more frequently in patients with pancreatic insufficiency and those who have two severe mutations in both alleles of the CFTR gene. Pathological percentage of u-OC was found more frequently in adult CF patients and those not receiving vitamin K. However, it seems that there are no good predictive factors of vitamin K deficiency in CF patients in everyday clinical care. Early vitamin K supplementation in CF patients seems to be warranted. It is impossible to clearly determine the supplementation dose. Therefore, constant monitoring of vitamin K status seems to be justified.

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