scholarly journals Vitamin K in Chronic Kidney Disease

Nutrients ◽  
2019 ◽  
Vol 11 (1) ◽  
pp. 168 ◽  
Author(s):  
Mario Cozzolino ◽  
Michela Mangano ◽  
Andrea Galassi ◽  
Paola Ciceri ◽  
Piergiorgio Messa ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
At Risk ◽  
Kidney Disease ◽  
Vitamin K ◽  
Bone Health ◽  
Vitamin K Deficiency ◽  
Population At Risk ◽  
K Deficiency ◽  
Subclinical Vitamin ◽  
Fat Soluble Vitamins

Vitamin K is a composite term referring to a group of fat-soluble vitamins that function as a cofactor for the enzyme γ-glutamyl carboxylase (GGCX), which activates a number of vitamin K-dependent proteins (VKDPs) involved in haemostasis and vascular and bone health. Accumulating evidence demonstrates that chronic kidney disease (CKD) patients suffer from subclinical vitamin K deficiency, suggesting that this represents a population at risk for the biological consequences of poor vitamin K status. This deficiency might be caused by exhaustion of vitamin K due to its high requirements by vitamin K-dependent proteins to inhibit calcification.

P0895THE RELATIONSHIP OF ARTERIAL CALCIFICATIONS IN CHRONIC KIDNEY DISEASE PATIENTS WITH INDIRECT ANTICOAGULANT INTAKE AND HEART MORBIDITY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Asen Kamenov ◽  
Stoyanka Georgieva ◽  
Dobrina Mlachkova ◽  
Daniela Valentinova Monova
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Vertebral Body ◽  
Vitamin K ◽  
Abdominal Aorta ◽  
Lumbar Vertebrae ◽  
Calcium Score ◽  
Arterial Calcification ◽  
Vitamin K Deficiency ◽  
K Deficiency

Abstract Background and Aims In patients with chronic kidney disease (CKD), arterial calcification (AC) is a potential mechanism for the progression of cardiovascular disease. AC is common in CKD patients and is a consequence of mineral-bone disorders. Indirect anticoagulants or vitamin K deficiency lead to matrix γ-carboxyglutamate decarboxylation, which may potentiate vascular calcification formation. The impaired renal function and indirect anticoagulants intake may lead to vitamin K deficiency and increased AC. The aim of this study is to determine if oral intake of Acenocoumarol has influence on abdominal aorta calcium score (AACS) and the AC relation with atrial fibrillation (AF) and / or ischemic heart disease (IHD) morbidity. Method We observe 129 patients with CKD (glomerular filtration rate below 44 ml/min/1,73 m2, MDRD formula calculated). X - ray of the lateral abdominal aorta is performed for the AACS assessment according to L. I. Kauppila et al. method. The assessment of calcium score is formed by the involvement grade of each segment on the anterior and posterior wall of the vessel along the first four lumbar vertebrae. Calcification affecting less than 1/3 of the anterior wall of the aorta along the lumbar vertebral body receives 1 score and calcification extending over ½ of the vertebral body length receives 3 scores (total score - 24). The patients are distributed into three groups: I group with calcium score from 0 to 7, II - from 8 to 15 and III group - from 16 to 24. The data from assessed AACS are compared with Acenocoumarol intake and the presence/absence of AF and/or IHD. The results are processed with χ2 statistical analysis. Results One hundred twenty nine patients with CKD (95 males and 34 females) are included in the study. The patients data (mean, percentages, degrees, etc.) are summarized in tabl.1 and tabl. 2. Clinically significant is the correlation between the grades of AACS and Acenocoumarol intake (p < 0,05). With the calcium score increasing, the patients percentage treated with Acenocoumarol also increases (fig. 1). There is a moderate correlation (Cramer’s coefficient is 0,39) between the AACS grades and heart morbidity from AF and / or IHD (p < 0,05). The data shows that the higher calcium score is related with increased patients percentage with AF and / or IHD morbidity (fig. 2). In our study, vascular calcifications are found in the abdominal aorta walls in all of the observed patients. We found that a higher AACS is associated with an Acenocoumarol intake in CKD patients and corresponds to an increased morbidity of AF and / or IHD. Acenocoumarol intake may lead to increased AACS. The higher calcium score is associated with a higher incidence of AF and / or IHD morbidity. Conclusion The study outcome supported the hypothesis that the increased AC formation and cardiovascular morbidity high risk could be a reason for the limited vitamin K antagonists (acenocoumarol) use in CKD patients. Furthermore, vitamin K2 supplementation is reasonable and may reduce the progression of AC.

Vitamin K Metabolism in a Rat Model of Chronic Kidney Disease

2016 ◽  
Vol 45 (1) ◽  
pp. 4-13 ◽  
Author(s):  
Kristin M. McCabe ◽  
Sarah L. Booth ◽  
Xueyan Fu ◽  
Emilie Ward ◽  
Michael A. Adams ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Vitamin K ◽  
Rat Model ◽  
Relative Increase ◽  
Kidney Cortex ◽  
Vitamin K Deficiency ◽  
Tissue Concentrations ◽  
K Deficiency ◽  
Very High

Background: Patients with chronic kidney disease (CKD) have very high levels of uncarboxylated, inactive, extra-hepatic vitamin K-dependent proteins measured in circulation, putting them at risk for complications of vitamin K deficiency. The major form of vitamin K found in the liver is phylloquinone (K1). Menaquinone-4 (MK-4) is the form of vitamin K that is preferentially found in extra-hepatic tissues. Methods: In the present study, we assessed tissue concentrations of K1 and MK-4 and the expression of vitamin K-related genes in a rat model of adenine-induced CKD. Results: It was found that rats with both mild and severe CKD had significantly lower amounts of K1 measured in liver, spleen and heart and higher levels of MK-4 measured in kidney cortex and medulla. All animals treated with high dietary K1 had an increase in tissue levels of both K1 and MK-4; however, the relative increase in K1 differed suggesting that the conversion of K1 to MK-4 may be a regulated/limiting process in some tissues. There was a decrease in the thoracic aorta expression of vitamin K recycling (Vkor) and utilization (Ggcx) enzymes, and a decrease in the kidney level of vitamin K1 to MK-4 bioconversion enzyme Ubiad1 in CKD. Conclusion: Taken together, these findings suggest that CKD impacts vitamin K metabolism, and this occurs early in the disease course. Our findings that vitamin K metabolism is altered in the presence of CKD provides further support that sub-clinical vitamin K deficiency may represent a modifiable risk factor for vascular and bone health in this population.

scholarly journals Functional vitamin K insufficiency, vascular calcification and mortality in advanced chronic kidney disease: A cohort study

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0247623
Author(s):  
Lu Dai ◽  
Longkai Li ◽  
Helen Erlandsson ◽  
Armand M. G. Jaminon ◽  
Abdul Rashid Qureshi ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Vascular Calcification ◽  
Vitamin K ◽  
Matrix Gla Protein ◽  
Vitamin K Deficiency ◽  
Increased Risk ◽  
Ckd Stage ◽  
All Cause Mortality ◽  
K Deficiency

Patients with chronic kidney disease (CKD) suffer from vitamin K deficiency and are at high risk of vascular calcification (VC) and premature death. We investigated the association of functional vitamin K deficiency with all-cause mortality and whether this association is modified by the presence of VC in CKD stage 5 (CKD G5). Plasma dephosphorylated-uncarboxylated matrix Gla-protein (dp-ucMGP), a circulating marker of functional vitamin K deficiency, and other laboratory and clinical data were determined in 493 CKD G5 patients. VC was assessed in subgroups by Agatston scoring of coronary artery calcium (CAC) and aortic valve calcium (AVC). Backward stepwise regression did not identify dp-ucMGP as an independent determinant of VC. During a median follow-up of 42 months, 93 patients died. Each one standard deviation increment in dp-ucMGP was associated with increased risk of all-cause mortality (sub-hazard ratio (sHR) 1.17; 95% confidence interval, 1.01–1.37) adjusted for age, sex, cardiovascular disease, diabetes, body mass index, inflammation, and dialysis treatment. The association remained significant when further adjusted for CAC and AVC in sub-analyses (sHR 1.22, 1.01–1.48 and 1.27, 1.01–1.60, respectively). In conclusion, functional vitamin K deficiency associates with increased mortality risk that is independent of the presence of VC in patients with CKD G5.

scholarly journals The Vitamin K Metabolome in Chronic Kidney Disease

Nutrients ◽  
2018 ◽  
Vol 10 (8) ◽  
pp. 1076 ◽  
Author(s):  
Mandy Turner ◽  
Michael Adams ◽  
Rachel Holden
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Vitamin K ◽  
Cardiovascular Events ◽  
Vitamin K Deficiency ◽  
Ectopic Mineralization ◽  
K Deficiency ◽  
Activity Of Enzymes ◽  
The Impact ◽  
Tissue Vitamin

The purpose of this review is to summarize the research to date on the impact of chronic kidney disease (CKD) on the vitamin K metabolome. Vitamin K-dependent proteins contribute to cardiovascular disease (CVD) prevention via the prevention of ectopic mineralization. Sub-clinical vitamin K deficiency is common in CKD patients, and evidence suggests that it may contribute to the CVD burden in this population. Research from animal models suggests that CKD alters tissue measures of the two predominant forms of vitamin K: KI and MK-4. The expression and/or activity of enzymes that regulate the recycling of vitamin K and the carboxylation of vitamin K-dependent proteins also appear to be altered in CKD. Evidence suggests that statins, a common pharmaceutical prescribed to CKD patients to prevent cardiovascular events, may impact the metabolism of vitamin K and therefore contribute to its relative inefficiency at preventing CVD in this population as kidney disease progresses. Human research on the tissue vitamin K metabolome in CKD patients is lacking.

scholarly journals Vitamin K Deficiency in Chronic Kidney Disease: Evidence Is Building Up

2016 ◽  
Vol 45 (1) ◽  
pp. 1-3 ◽  
Author(s):  
Maria Fusaro ◽  
Mario Plebani ◽  
Giorgio Iervasi ◽  
Maurizio Gallieni
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Vitamin K ◽  
Vitamin K Deficiency ◽  
K Deficiency

scholarly journals Vitamin K and D Supplementation and Bone Health in Chronic Kidney Disease—Apart or Together?

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 809
Author(s):  
Marta Ziemińska ◽  
Beata Sieklucka ◽  
Krystyna Pawlak
Keyword(s):  
Chronic Kidney Disease ◽  
Vitamin D ◽  
Kidney Disease ◽  
Vitamin K ◽  
Bone Health ◽  
Clinical Evidence ◽  
Mechanisms Of Action ◽  
Preclinical Studies ◽  
Normal Bone ◽  
Combined Supplementation

Vitamin K (VK) and vitamin D (VD) deficiency/insufficiency is a common feature of chronic kidney disease (CKD), leading to impaired bone quality and a higher risk of fractures. CKD patients, with disturbances in VK and VD metabolism, do not have sufficient levels of these vitamins for maintaining normal bone formation and mineralization. So far, there has been no consensus on what serum VK and VD levels can be considered sufficient in this particular population. Moreover, there are no clear guidelines how supplementation of these vitamins should be carried out in the course of CKD. Based on the existing results of preclinical studies and clinical evidence, this review intends to discuss the effect of VK and VD on bone remodeling in CKD. Although the mechanisms of action and the effects of these vitamins on bone are distinct, we try to find evidence for synergy between them in relation to bone metabolism, to answer the question of whether combined supplementation of VK and VD will be more beneficial for bone health in the CKD population than administering each of these vitamins separately.

Prevalence of subclinical vitamin K deficiency in Thai newborns: relationship to maternal phylloquinone intakes and delivery risk

2009 ◽  
Vol 95 (2) ◽  
pp. F104-F108 ◽  
Author(s):  
A. Chuansumrit ◽  
T. Plueksacheeva ◽  
S. Hanpinitsak ◽  
S. Sangwarn ◽  
S. Chatvutinun ◽  
...  
Keyword(s):  
Vitamin K ◽  
Vitamin K Deficiency ◽  
K Deficiency ◽  
Subclinical Vitamin
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