Title:Vitamin K Supplementation in Chronic Kidney Disease Patients: Where is
the Evidence?
Volume: 20
Issue: 2
Author(s): Stefanos Roumeliotis*, Vassilios Liakopoulos and Leon J. Schurgers
Affiliation:
- Division of Nephrology and Hypertension, 1st Department of Internal Medicine, AHEPA Hospital, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
Keywords:
Chronic kidney disease, dephosphorylated uncarboxylated MGP, end stage kidney disease, matrix gla protein, vascular calcification, vitamin K2.
Abstract: Vascular calcification (VC) is highly prevalent in Chronic Kidney Disease (CKD) patients,
progresses gradually with deterioration of kidney function and is a strong, independent predictor of
cardiovascular (CV) mortality. Matrix Gla Protein (MGP), the most potent inhibitor of VC, requires
vitamin K as a co-factor to become biologically active. Accumulating epidemiological data have associated
vitamin K depletion with VC progression and CV outcomes. CKD patients are characterized by
poor vitamin K status and at the same time, pronounced CV calcification. In early and advanced CKD,
including end-stage kidney disease, exogenous supplementation of vitamin K (especially with menaquinone
7, its most bioavailable form) might decrease the inactive form of MGP (dephosphorylated, uncarboxylated
MGP) and probably retard the progression or even reverse VC. Here, we focus and discuss
the interventional human studies of vitamin K supplementation in CKD patients and suggest future directions
in this area of interest.