Is Fasting Required for PIVKA-II Testing?
No, fasting is not required for PIVKA-II (Protein Induced by Vitamin K Absence or Antagonist-II) testing.
Pre-Test Requirements
PIVKA-II is a blood test that measures abnormal des-carboxylated prothrombin, which serves as a biomarker for vitamin K deficiency and is used in monitoring patients after bariatric surgery and in hepatocellular carcinoma diagnosis 1. The available guidelines and research do not specify any fasting requirements for this test.
Key Points About PIVKA-II Testing
No dietary restrictions are needed - Unlike some metabolic tests, PIVKA-II measurement does not require patients to be fasting 1
Standard blood draw - PIVKA-II is measured through routine serum or plasma collection using chemiluminescent enzyme immunoassay (CLEIA) methods 2, 3
Timing considerations - The test can be performed at any time of day without regard to meal timing, as food intake does not interfere with the measurement of abnormal prothrombin species 1, 2
Clinical Context
Bariatric surgery monitoring - Guidelines recommend checking PIVKA-II levels at regular intervals (at least annually) following malabsorptive procedures such as biliopancreatic diversion with duodenal switch (BPD/DS), with no mention of fasting requirements 1
Vitamin K status assessment - PIVKA-II is recognized as a sensitive homeostatic biomarker of hepatic subclinical vitamin K deficiency, and its measurement requires special preanalytical conditions to prevent vitamin K degradation by light exposure, alkaline conditions, and temperature - but not fasting 1
HCC screening - When used for hepatocellular carcinoma diagnosis, PIVKA-II testing does not require fasting, making it convenient for routine surveillance 3, 4, 5
Important Preanalytical Considerations
While fasting is not required, proper sample handling is critical:
Light protection - Samples must be protected from light exposure to prevent vitamin K degradation 1
Temperature control - Appropriate storage conditions must be maintained 1
Avoid alkaline conditions - Special care must be taken to prevent exposure to alkaline conditions that could degrade vitamin K 1