Efficacy of Intravenous Vitamin K in Correcting Deranged International Normalized Ratio in Chronic Liver Disease

Authors

  • Sana Muhammad Hussain
  • Tahreem sajjad
  • Shaheera Zaidi
  • Amanullah Abbasi

Keywords:

Chronic liver disease, vitamin K, cirrhosis, INR, coagulopathy., Child–Pugh Classification (CTP).

Abstract

OBJECTIVE: To study the efficacy of intravenous vitamin K in deranged INR in chronic liver disease.

METHODOLOGY: This observational cross-sectional study at a tertiary care hospital included CLD patients (?18 years) with baseline INR >1.3 who received three doses of vitamin K. Exclusions were acute liver failure, missing INR data, anticoagulant use, or blood transfusion within 72 hours before or between PT-INR sampling. The mean INR change was compared by dosing frequency (single vs multiple) and Child–Pugh class. Data were analyzed using SPSS version 24.

RESULTS: 80 patients included, with 58.75% males and 41.25% females, of whom CTP A, B, and C were 5%, 15%, and 80%, respectively. The mean change in INR after the 1st and 3rd doses was 0.078±0.265; P = 0.01 and 0.1403±0.382; P = 0.002, respectively. The mean change in INR between single versus three doses was -0.056±0.33; P = 0.049. The mean change in INR after the 1st and 3rd doses in CTP A was 0.195±0.404; P=0.001 and 0.0250±0.635; P=0.005, respectively. The mean change in INR after the 1st and 3rd doses in CTP B was 0.0825±0.449; P = < 0.001 and 0.0717±0.15; P= < 0.001, respectively. The mean change in INR after the 1st and 3rd doses in CTP C was 0.077±0.299; P= < 0.001 and 0.160 ± 0.420; P= < 0.001, respectively.

CONCLUSION: Overall, the majority of CLD patients showed improvement in INR after three doses of vitamin K, primarily CTP C.

References

1. Moon AM, Singal AG, Tapper EB. Contemporary Epidemiology of Chronic Liver Disease and Cirrhosis. Clinical Gastroenterology and Hepatology. 2019 Aug; 18(12).

2. Wong MCS, Huang JLW, George J, Huang J, Leung C, Eslam M, et al. The changing epidemiology of liver diseases in the Asia-Pacific region. Nat Rev Gastroenterol Hepatol. 2019; 16(1): 57–73.

3. Smith CB, Hennessey E, Crossey CD, Crannage AJ. Impact of Vitamin K Administration on Elevated International Normalized Ratio in Chronic Liver Disease. Clinical and Applied Thrombosis-Hemostasis. 2023; 29: 107602962311646-107602962311646.

4. Aldrich SM, Regal RE. Routine Use of Vitamin K in the Treatment of Cirrhosis-Related Coagulopathy: Is it A-O-K? Maybe Not, We Say. P & T: a peer-reviewed journal for formulary management. 2019 Mar; 44(3): 131–136.

5. Puri P, Dhiman RK, Taneja S, Tandon P, Merli M, Anand AC, et al. Nutrition in Chronic Liver Disease: Consensus Statement of the Indian National Association for Study of the Liver. Journal of Clinical and Experimental Hepatology. 2021 Jan;11(1):97–143.

6. Martí?Carvajal AJ, Solà I. Vitamin K for upper gastrointestinal bleeding in people with acute or chronic liver diseases. The Cochrane Database of Systematic Reviews. 2015 Jun 9; 2015(6): CD004792.

7. Hambley BC, Diamond A, Connie S, Partovi S, Smith T, LoPresti C. Effect of Vitamin K on Coagulopathy of Liver Disease: A Single Center Retrospective Review. Blood. 2016 Dec 2; 128(22): 2583–3.

8. Al Sulaiman K, Al Mutairi M, Al Harbi O, Al Duraihim A, Aldosary S, Al Khalil H et al. Appropriateness of Using Vitamin K for the Correction of INR Elevation Secondary to Hepatic Disease in Critically ill Patients: An Observational Study. Clin Appl Thrombosis/Hemostasis. 2021 Jan; 27: 107602962110509.

9. Jin S, Hong L, FakhriRavari A. The Role of Vitamin K in Cirrhosis: Do Pharmaco-K-Netics Matter? Gastrointestinal Disorders. 2022 Mar 1; 4(1): 15–21.

10. Saja MF, Abdo AA, Sanai FM, Shaikh SA, Gader AGMA. The coagulopathy of liver disease. Blood Coagulation & Fibrinolysis. 2013 Jan; 24(1): 10–7.

11. Rivosecchi RM, Kane-Gill SL, Garavaglia J, MacLasco A, Johnson H. The effectiveness of intravenous vitamin K in correcting cirrhosis-associated coagulopathy. Int J Pharm Pract. 2017 Feb 17; 25(6): 463–465.

12. Blanchard RA, Furie BC, Jorgensen M, Kruger SF, Furie B. Acquired vitamin K-dependent carboxylation deficiency in liver disease. N Engl J Med. 1981; 305(5): 242–8.

13. Amarapurkar PD, Amarapurkar DN. Management of Coagulopathy in Patients with Decompensated Liver Cirrhosis. Int J Hepatol. 2011; 2011: 1–5.

14. Williams R. Sherlock’s disease of the liver and biliary systems. Clin Med. 2011 Oct; 11(5): 506–6.

15. Liang Y. Bleeding Risk in Asian Patients: Potential for Thrombin Amplification Pathway Blockade Using Factor XI Inhibitors. JACC Asia. 2024; 4(2): 163-165.

Downloads

Published

30-04-2026

How to Cite

1.
Muhammad Hussain S, sajjad T, Zaidi S, Abbasi A. Efficacy of Intravenous Vitamin K in Correcting Deranged International Normalized Ratio in Chronic Liver Disease. J Liaq Uni Med Health Sci [Internet]. 2026 Apr. 30 [cited 2026 May 1];25(02):128-31. Available from: http://ojs.lumhs.edu.pk/index.php/jlumhs/article/view/1515

Similar Articles

<< < 2 3 4 5 6 7 8 9 > >> 

You may also start an advanced similarity search for this article.