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Vitamin K and the management of patients with cystic fibrosis.
CMAJ 1994; 151(7):933-6CMAJ

Abstract

OBJECTIVE

To assess the advisability of routine vitamin K supplementation in patients with cystic fibrosis (CF).

DATA SOURCES

Studies identified through a MEDLINE search with the use of MeSH terms vitamin K, cystic fibrosis, PIVKA-II (protein induced by vitamin K absence-II), coagulation abnormality and cystic fibrosis, and hepatic disorder and cystic fibrosis.

STUDY SELECTION

Six articles published between January 1981 and December 1992 were selected: one general review of vitamin K in infancy and five studies involving clinical trials of vitamin K supplementation or screening for fat-soluble vitamins, vitamin K or PIVKA-II in patients with CF. Review articles on nutrition in patients with CF, technical reports, letters, comments and case studies not bearing directly on these issues were excluded.

DATA EXTRACTION

Findings in these articles were analysed and compared to determine whether routine supplementation in all patients with CF is indicated, whether specific subgroups of these patients are susceptible to vitamin K deficiency and areas in which future research is needed.

RESULTS

There is no consensus on routine vitamin K supplementation in patients with CF. Studies have found a few cases of vitamin K deficiency among the population of people with CF. In addition, various factors--including pancreatic failure, liver disease, bowel resection and long-term use of antibiotics--can put some of these patients at risk of vitamin K deficiency.

CONCLUSIONS

Specific indications for routine vitamin K supplementation in all patients with CF have not yet been identified. Pending further studies, it would be prudent to consider routine supplementation in patients with CF and severe noncholestatic and cholestatic liver disease, major small-bowel resection, pancreatic insufficiency or lung disease necessitating frequent use of antibiotics. A stronger body of evidence is needed as a basis for clinical strategies.

Authors+Show Affiliations

Department of Pediatrics, University of Toronto, Ont.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

7922929

Citation

Durie, P R.. "Vitamin K and the Management of Patients With Cystic Fibrosis." CMAJ : Canadian Medical Association Journal = Journal De l'Association Medicale Canadienne, vol. 151, no. 7, 1994, pp. 933-6.
Durie PR. Vitamin K and the management of patients with cystic fibrosis. CMAJ. 1994;151(7):933-6.
Durie, P. R. (1994). Vitamin K and the management of patients with cystic fibrosis. CMAJ : Canadian Medical Association Journal = Journal De l'Association Medicale Canadienne, 151(7), pp. 933-6.
Durie PR. Vitamin K and the Management of Patients With Cystic Fibrosis. CMAJ. 1994 Oct 1;151(7):933-6. PubMed PMID: 7922929.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vitamin K and the management of patients with cystic fibrosis. A1 - Durie,P R, PY - 1994/10/1/pubmed PY - 1994/10/1/medline PY - 1994/10/1/entrez SP - 933 EP - 6 JF - CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne JO - CMAJ VL - 151 IS - 7 N2 - OBJECTIVE: To assess the advisability of routine vitamin K supplementation in patients with cystic fibrosis (CF). DATA SOURCES: Studies identified through a MEDLINE search with the use of MeSH terms vitamin K, cystic fibrosis, PIVKA-II (protein induced by vitamin K absence-II), coagulation abnormality and cystic fibrosis, and hepatic disorder and cystic fibrosis. STUDY SELECTION: Six articles published between January 1981 and December 1992 were selected: one general review of vitamin K in infancy and five studies involving clinical trials of vitamin K supplementation or screening for fat-soluble vitamins, vitamin K or PIVKA-II in patients with CF. Review articles on nutrition in patients with CF, technical reports, letters, comments and case studies not bearing directly on these issues were excluded. DATA EXTRACTION: Findings in these articles were analysed and compared to determine whether routine supplementation in all patients with CF is indicated, whether specific subgroups of these patients are susceptible to vitamin K deficiency and areas in which future research is needed. RESULTS: There is no consensus on routine vitamin K supplementation in patients with CF. Studies have found a few cases of vitamin K deficiency among the population of people with CF. In addition, various factors--including pancreatic failure, liver disease, bowel resection and long-term use of antibiotics--can put some of these patients at risk of vitamin K deficiency. CONCLUSIONS: Specific indications for routine vitamin K supplementation in all patients with CF have not yet been identified. Pending further studies, it would be prudent to consider routine supplementation in patients with CF and severe noncholestatic and cholestatic liver disease, major small-bowel resection, pancreatic insufficiency or lung disease necessitating frequent use of antibiotics. A stronger body of evidence is needed as a basis for clinical strategies. SN - 0820-3946 UR - https://www.unboundmedicine.com/medline/citation/7922929/Vitamin_K_and_the_management_of_patients_with_cystic_fibrosis_ L2 - http://www.cmaj.ca/cgi/pmidlookup?view=reprint&pmid=7922929 DB - PRIME DP - Unbound Medicine ER -