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Monday, January 19, 2015

Vitamin K supplementation for cystic fibrosis

Cochrane: We reviewed the evidence to see whether supplementing vitamin K in people with cystic fibrosis counteracts the effects of deficiency on blood clotting, bone strength and quality of life in people with cystic fibrosis. We tried to determine the best dose needed to prevent this deficiency.


Background
Cystic fibrosis is an inherited condition which causes disease, most noticeably in the lungs, digestive system and pancreas. In people with cystic fibrosis, the pancreas often does not produce enough enzymes to allow the body to absorb digested food properly and this may also be linked to deficiencies of fat-soluble vitamins like vitamin K. Vitamin K is needed for adequate blood clotting, bone formation and some metabolic functions.
Search date
The evidence is current to: 08 October 2014.
Study characteristics
We included two trials (total of 32 participants) in the review. In one trial (14 children aged 8 to 18 years old) for one month half of the participants were given oral vitamin K supplements at a dose of 1 mg/day and the other half were given 5 mg/day. In the second trial all the 18 volunteers (aged 13 to 35 years) were given 5 mg oral vitamin K supplement or nothing for one month and then they swapped to the other group for another month. Unfortunately, we could not analyse the data from this second trial because the investigators did not report data just from the first part of the trial (only from the end of the trial when all volunteers had been in both groups), so we could not tell if the effects were due to supplements or no supplements.
Key results
Neither trial addressed any of the review's primary outcomes (blood clotting, bone formation and quality of life). Both trials reported that in patients who had low levels of vitamin K measured in the blood and also another laboratory marker of vitamin K (undercarboxylated osteocalcin), these levels returned to the normal range after one month of daily supplementation with 1 mg of vitamin K.
Quality of the evidence
We were satisfied that both trials reported all the outcomes they planned to and that the results were not at risk of being biased due to volunteers dropping out of the trials. We did not have enough details to decide whether results would be affected by the way the trials were set up or in case volunteers could tell which treatment they were receiving (it would be obvious in the trial comparing supplements to no treatment),
- See more at: http://summaries.cochrane.org/CD008482/CF_vitamin-k-supplementation-for-cystic-fibrosis#sthash.XTxbw1hi.dpuf