title: Vitamin K Antagonist Therapy Is a Risk Factor for Ulcer Development and Death Among Dialyzed Patients.
abstract: Peripheral artery disease is a common complication among dialyzed patients. Since Vitamin K antagonists promote metastatic calcifications and these are the main determinants of vascular damage, we investigated their role in the development of lower limb ulcers in dialyzed patients. We retrospectively enrolled 316 dialyzed patients, aged 68 ± 15 years, 65% male, 32% diabetic, 43% with ischemic heart disease and followed them for 36 ± 25 months. 60 patients assumed Vitamin K antagonists: they were older, with a higher prevalence of heart disease, at greater risk of death and they developed more ulcers and underwent more lower limb amputations compared to the rest of our cohort. Peripheral artery disease, Vitamin K antagonists and diabetes were independent risk factors for foot lesions. In addition, Vitamin K antagonists were also an independent risk factor for death. Vitamin K antagonists are a potent independent risk factor for the development of the uremic foot syndrome and death.
authors.affiliation: Nephrology and Dialysis Unit, University Hospital "Maggiore della Carità", Novara, Italy.
authors.forename: Andreana
authors.initials: A
authors.lastname: De Mauri
authors.affiliation: Unit of Nephrology and Hemodialysis, IRCCS Fondazione Salvatore Maugeri, University of Pavia, Pavia, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Torreggiani
authors.affiliation: Medical Physics Department, University Hospital "Maggiore della Carità", Novara, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Brambilla
authors.affiliation: Nephrology and Dialysis Unit, University Hospital "Maggiore della Carità", Novara, Italy.
authors.forename: Doriana
authors.initials: D
authors.lastname: Chiarinotti
mesh_terms: D000368:Aged; D000671:Amputation, Surgical / Q000706:statistics & numerical data; D000925:Anticoagulants / Q000009:adverse effects*; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D016523:Foot Ulcer / Q000453:epidemiology*; D006801:Humans; D035002:Lower Extremity; D008297:Male; D058729:Peripheral Arterial Disease / Q000453:epidemiology*; D006435:Renal Dialysis; D012189:Retrospective Studies; D012307:Risk Factors; D014511:Uremia / Q000453:epidemiology; D014812:Vitamin K / Q000037:antagonists & inhibitors*
chemical_list: D000925:Anticoagulants; D014812:Vitamin K
keywords: Hemodialysis; Oral anticoagulation therapy; Ulcers; Uremic foot syndrome; Vitamin K