ReferenceID 394

Effect of vitamin K2 supplementation on functional vitamin K deficiency in hemodialysis patients: a randomized trial

Am J Kidney Dis

BACKGROUND: Vascular calcification is a predictor of cardiovascular morbidity and mortality. Hemodialysis patients experience severe vascular calcifications. Matrix Gla protein (MGP) is a central calcification inhibitor

Back to Browse

Relationship Network

Interactive first-hop connections across herbs, ingredients, formulas, targets, diseases, symptoms, syndromes, evidence, and monographs.

Click a node to open it in a new tab
Ingredient: 1Reference: 1Links: 1
Arranging relationship network...

Record Fields

Scalar fields from the final reference record.

Reference Id
394
Evidence Id
16984
Core Evidence Id
16984
Source Reference Id
760
Herb2 Reference Id
HBREF001321
Subject Paper Key
HBIN048069_22169620
Pubmed Id
22169620
Doi
10.1053/j.ajkd.2011.10.041
Paper Title
Effect of vitamin K2 supplementation on functional vitamin K deficiency in hemodialysis patients: a randomized trial
Paper Abstract
BACKGROUND: Vascular calcification is a predictor of cardiovascular morbidity and mortality. Hemodialysis patients experience severe vascular calcifications. Matrix Gla protein (MGP) is a central calcification inhibitor of the arterial wall; its activity depends on vitamin K-dependent γ-glutamate carboxylation. Uncarboxylated MGP, formed as a result of vitamin K deficiency, is associated with cardiovascular disease. Recent studies suggest poor vitamin K status in hemodialysis patients. We therefore aimed to investigate whether daily vitamin K supplementation improves the bioactivity of vitamin K-dependent proteins in hemodialysis patients, assessed by circulating dephosphorylated-uncarboxylated MGP, uncarboxylated osteocalcin, and uncarboxylated prothrombin (PIVKA-II [protein induced by vitamin K absence II]). STUDY DESIGN: Interventional randomized non-placebo-controlled trial with 3 parallel groups. SETTING & PARTICIPANTS: 53 long-term hemodialysis patients in stable conditions, 18 years or older. 50 healthy age-matched individuals served as controls. INTERVENTIONS: Menaquinone-7 (vitamin K(2)) treatment at 45, 135, or 360 μg/d for 6 weeks. OUTCOMES: Plasma levels of dephosphorylated-uncarboxylated MGP, uncarboxylated osteocalcin, and PIVKA-II. MEASUREMENTS: Plasma levels were assessed using enzyme-linked immunosorbent assays. RESULTS: At baseline, hemodialysis patients had 4.5-fold higher dephosphorylated-uncarboxylated MGP and 8.4-fold higher uncarboxylated osteocalcin levels compared with controls. PIVKA-II levels were elevated in 49 hemodialysis patients. Vitamin K(2) supplementation induced a dose- and time-dependent decrease in circulating dephosphorylated-uncarboxylated MGP, uncarboxylated osteocalcin, and PIVKA-II levels. Response rates in the reduction in dephosphorylated-uncarboxylated MGP levels were 77% and 93% in the groups receiving 135 μg and 360 μg of menaquinone-7, respectively. LIMITATIONS: Small sample size. CONCLUSIONS: This study confirms that most hemodialysis patients have a functional vitamin K deficiency. More importantly, it is the first study showing that inactive MGP levels can be decreased markedly by daily vitamin K(2) supplementation. Our study provides the rationale for intervention trials aimed at decreasing vascular calcification in hemodialysis patients by vitamin K supplementation.
Journal
Am J Kidney Dis
Publish Year
2012
Experiment Subject
53 long-term hemodialysis patients in stable conditions, 18 years or older. 50 healthy age-matched individuals served as controls.
Experiment Type
Clinical Experiment
Phenotype Related
Paper Title Cn
Paper Title En
Effect of vitamin K2 supplementation on functional vitamin K deficiency in hemodialysis patients: a randomized trial
Bilingual Status
semi_complete