Vitamin K Supplementation for Prevention of Vascular Calcification in Chronic Kidney Disease Patients: Are We There Yet?

• Published in: Nutrients Vol. 14; no. 5; p. 925
• Main Authors: Roumeliotis, Stefanos, Duni, Anila, Vaios, Vasilios, Kitsos, Athanasios, Liakopoulos, Vassilios, Dounousi, Evangelia
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 22.02.2022; MDPI
• Subjects: Arteriosclerosis; Biological activity; Calcification; Calcification (ectopic); Carboxylation; cardiovascular disease; Cardiovascular diseases; Cartilage; chronic kidney disease; Clinical trials; Depletion; Dialysis; Dietary Supplements; end-stage kidney disease; Hemodialysis; Humans; Hydroxyapatite; Inflammation; Inhibitors; Kidney diseases; Kidneys; Matrix Gla Protein; menaquinone-7; Metabolism; Mineralization; Morbidity; Mortality; Oxidative stress; Pathophysiology; Patients; Phosphorylation; Phylloquinone; Post-translation; Proteins; Renal Dialysis - adverse effects; Renal Insufficiency, Chronic - complications; Review; Smooth muscle; Stiffness; Vascular Calcification - complications; Vascular Calcification - prevention & control; Veins & arteries; Vitamin deficiency; Vitamin K; cardiovascular disease; chronic kidney disease; end-stage kidney disease; menaquinone-7; vascular calcification; hemodialysis; Matrix Gla Protein; vitamin K
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu14050925

Chronic Kidney Disease (CKD) patients are at high risk of presenting with arterial calcification or stiffness, which confers increased cardiovascular mortality and morbidity. In recent years, it has become evident that VC is an active process regulated by various molecules that may act as inhibitors of vessel mineralization. Matrix Gla Protein (MGP), one the most powerful naturally occurring inhibitors of arterial calcification, requires vitamin K as a co-factor in order to undergo post-translational γ-carboxylation and phosphrorylation and become biologically active. The inactive form of MGP (dephosphorylated, uncarboxylated dp-ucMGP) reflects vitamin K deficiency and has been repeatedly associated with surrogate markers of VC, stiffness, and cardiovascular outcomes in CKD populations. As CKD is a state of progressive vitamin K depletion and VC, research has focused on clinical trials aiming to investigate the possible beneficial effects of vitamin K in CKD and dialysis patients. In this study, we aim to review the current evidence regarding vitamin K supplementation in uremic patients.