NCT02278692

Brief Summary

Calcific uremic arteriolopathy a.k.a. calciphylaxis is a vascular calcification disorder seen in dialysis patients. Calcific uremic arteriolopathy has 60-80% one-year mortality and significant morbidity associated with non-healing and extremely painful skin lesions. At present, there is no effective treatment for calcific uremic arteriolopathy. Vitamin K is an important vitamin for inhibiting vascular calcification. It is known to increase the circulating levels of carboxylated Matrix Gla Protein, a potent inhibitor of vascular calcification. However, the effects of vitamin K supplementation in patients with calcific uremic arteriolopathy are unknown. The purpose of this study is to conduct a pilot randomized controlled trial to examine the effects of oral vitamin K supplementation on circulating levels of anti-calcification factor (carboxylated Matrix Gla Protein) and clinical outcomes in patients with calcific uremic arteriolopathy.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
26

participants targeted

Target at below P25 for not_applicable

Timeline
Completed

Started Mar 2015

Longer than P75 for not_applicable

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

October 27, 2014

Completed
3 days until next milestone

First Posted

Study publicly available on registry

October 30, 2014

Completed
4 months until next milestone

Study Start

First participant enrolled

March 1, 2015

Completed
4.4 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

August 1, 2019

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

August 1, 2019

Completed
Last Updated

September 17, 2019

Status Verified

September 1, 2019

Enrollment Period

4.4 years

First QC Date

October 27, 2014

Last Update Submit

September 15, 2019

Conditions

Keywords

Vitamin KCalciphylaxisCalcific uremic arteriolopathyDialysisEnd-stage renal disease

Outcome Measures

Primary Outcomes (1)

  • Change from baseline in circulating MGP level at 12 weeks

    Baseline and 12 weeks

Secondary Outcomes (3)

  • Change from baseline in largest lesion size at 12 weeks

    Baseline and every month for 3 months

  • Change from baseline in combined area of all lesions at 12 weeks

    Baseline and every month for 3 months

  • Change from baseline in pain at 12 weeks

    Baseline and every month for 3 months

Other Outcomes (1)

  • Adverse events

    Baseline and every month for 3 months

Study Arms (2)

Vitamin K

ACTIVE COMPARATOR

Vitamin K1 (phytonadione) 10 mg orally three times a week after dialysis for 12 weeks

Dietary Supplement: Vitamin K

Placebo

PLACEBO COMPARATOR

Identical appearing placebo orally three times a week after dialysis for 12 weeks

Other: Placebo

Interventions

Vitamin KDIETARY_SUPPLEMENT

Oral vitamin K

Vitamin K
PlaceboOTHER

Oral placebo tablet

Placebo

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Calcific uremic arteriolopathy (a.k.a. calciphylaxis)

You may not qualify if:

  • Warfarin discontinuation contra-indicated (e.g. mechanical heart valve)
  • Prior allergic reaction to vitamin K
  • Prior history of venous thromboembolism\*
  • Pregnancy and lactation

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Massachusetts General Hospital

Boston, Massachusetts, 02114, United States

Location

Related Publications (7)

  • Nigwekar SU, Brunelli SM, Meade D, Wang W, Hymes J, Lacson E Jr. Sodium thiosulfate therapy for calcific uremic arteriolopathy. Clin J Am Soc Nephrol. 2013 Jul;8(7):1162-70. doi: 10.2215/CJN.09880912. Epub 2013 Mar 21.

    PMID: 23520041BACKGROUND
  • Nigwekar SU, Bhan I, Turchin A, Skentzos SC, Hajhosseiny R, Steele D, Nazarian RM, Wenger J, Parikh S, Karumanchi A, Thadhani R. Statin use and calcific uremic arteriolopathy: a matched case-control study. Am J Nephrol. 2013;37(4):325-32. doi: 10.1159/000348806. Epub 2013 Mar 21.

    PMID: 23548843BACKGROUND
  • Nigwekar SU, Bloch DB, Nazarian RM, Vermeer C, Booth SL, Xu D, Thadhani RI, Malhotra R. Vitamin K-Dependent Carboxylation of Matrix Gla Protein Influences the Risk of Calciphylaxis. J Am Soc Nephrol. 2017 Jun;28(6):1717-1722. doi: 10.1681/ASN.2016060651. Epub 2017 Jan 3.

    PMID: 28049648BACKGROUND
  • Nigwekar SU, Zhao S, Wenger J, Hymes JL, Maddux FW, Thadhani RI, Chan KE. A Nationally Representative Study of Calcific Uremic Arteriolopathy Risk Factors. J Am Soc Nephrol. 2016 Nov;27(11):3421-3429. doi: 10.1681/ASN.2015091065. Epub 2016 Apr 14.

    PMID: 27080977BACKGROUND
  • Cozzolino M, Mangano M, Galassi A, Ciceri P, Messa P, Nigwekar S. Vitamin K in Chronic Kidney Disease. Nutrients. 2019 Jan 14;11(1):168. doi: 10.3390/nu11010168.

    PMID: 30646590BACKGROUND
  • D Shirsat P, Sonavane K, Botana LR, Sachdeva B. Calciphylaxis in the Upper GI Tract in an ESRD Patient: An Atypical Presentation and Review of Literature. Case Rep Nephrol. 2025 Dec 11;2025:3967671. doi: 10.1155/crin/3967671. eCollection 2025.

  • Krishnasamy R, Jardine MJ; BEAT-Calci Trialists. Adaptive Designs for Clinical Trials in Nephrology. J Am Soc Nephrol. 2025 Jan 1;36(1):147-149. doi: 10.1681/ASN.0000000000000497. Epub 2024 Aug 26. No abstract available.

Related Links

MeSH Terms

Conditions

CalciphylaxisKidney Failure, Chronic

Interventions

Vitamin K

Condition Hierarchy (Ancestors)

CalcinosisCalcium Metabolism DisordersMetabolic DiseasesNutritional and Metabolic DiseasesRenal Insufficiency, ChronicRenal InsufficiencyKidney DiseasesUrologic DiseasesFemale Urogenital DiseasesFemale Urogenital Diseases and Pregnancy ComplicationsUrogenital DiseasesMale Urogenital DiseasesChronic DiseaseDisease AttributesPathologic ProcessesPathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

NaphthoquinonesNaphthalenesPolycyclic Aromatic HydrocarbonsHydrocarbons, AromaticHydrocarbons, CyclicHydrocarbonsOrganic ChemicalsPhytolDiterpenesTerpenesPolycyclic Compounds

Study Officials

  • Sagar Nigwekar, MD, MMSc

    Massachusetts General Hospital

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
QUADRUPLE
Who Masked
PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Assistant Physician

Study Record Dates

First Submitted

October 27, 2014

First Posted

October 30, 2014

Study Start

March 1, 2015

Primary Completion

August 1, 2019

Study Completion

August 1, 2019

Last Updated

September 17, 2019

Record last verified: 2019-09

Locations