Zhou Sun, Kejing Zhu, Guofu Liang, Fu Yan, Sheng Chao, Lei Jia, Yulin Niu
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引用次数: 0
Abstract
The effect of vitamin K on clinical outcomes in patients receiving kidney transplantation is contested according to previous studies. This meta-analysis aimed to summarize the impact of vitamin K on all-cause mortality, renal function, inflammation, and vascular/bone health in patients receiving kidney transplantation. EMBASE, PubMed, and Cochrane were searched for literature concerning the effect of vitamin K on clinical outcomes of patients receiving kidney transplantation until December 2022. Normal vitamin K status/vitamin K supplementation was considered as the experimental group; while vitamin K deficiency/no vitamin K supplementation was considered as the control group. All-cause mortality, renal function indexes, C-reactive protein (CRP), and vascular/bone health indexes were extracted and analyzed. A total of seven studies with 1,101 patients in the experimental group and 651 patients in the control group were included. All-cause mortality was decreased in the experimental group vs. the control group [relative risk (95% confidence interval (CI)]: 0.72 (0.60-0.86), P<0.001]. Regarding renal function indexes, the estimated glomerular filtration rate was increased in the experimental group vs. the control group [mean difference (95% CI): 9.87 (1.48-18.26), P=0.021]; while creatinine and albumin remained unchanged between the two groups (both P>0.05). Moreover, CRP, systolic blood pressure, diastolic blood pressure, triglycerides, hemoglobin, calcium, and 25-hydroxyvitamin D were unchanged between the two groups (all P>0.05). Publication bias was low, and the robustness assessed by sensitivity analysis was generally acceptable. Thus vitamin K exerted a potential implication in reducing all-cause mortality and improving renal function in patients receiving kidney transplantation.
根据以往的研究,维生素 K 对肾移植患者临床预后的影响存在争议。本荟萃分析旨在总结维生素 K 对肾移植患者全因死亡率、肾功能、炎症和血管/骨骼健康的影响。在 EMBASE、PubMed 和 Cochrane 中检索了截至 2022 年 12 月有关维生素 K 对肾移植患者临床结果影响的文献。将维生素 K 状态正常/补充维生素 K 的患者视为实验组;维生素 K 缺乏/未补充维生素 K 的患者视为对照组。研究人员提取并分析了全因死亡率、肾功能指数、C反应蛋白(CRP)和血管/骨骼健康指数。共纳入七项研究,其中实验组有 1,101 名患者,对照组有 651 名患者。实验组与对照组相比,全因死亡率有所下降[相对风险(95% 置信区间(CI)]:0.72(0.60-0.86),P<0.001]。在肾功能指标方面,实验组与对照组相比,估计肾小球滤过率有所增加[平均差异(95% CI):9.87 (1.48-18.26),P=0.021];而两组间肌酐和白蛋白保持不变(均为 P>0.05)。此外,两组间的 CRP、收缩压、舒张压、甘油三酯、血红蛋白、钙和 25- 羟维生素 D 均无变化(均为 P>0.05)。发表偏倚较低,敏感性分析评估的稳健性基本可以接受。因此,维生素 K 在降低肾移植患者的全因死亡率和改善肾功能方面具有潜在意义。