Journal
CALCIFIED TISSUE INTERNATIONAL
Volume 108, Issue 4, Pages 476-485Publisher
SPRINGER
DOI: 10.1007/s00223-020-00792-2
Keywords
Vitamin K; Bone fractures; Osteocalcin; Matrix Gla protein; CKD
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Vitamin K plays a crucial role in blood coagulation and is associated with fragility fractures, vascular calcification, and mortality. It exists in two main forms, Phylloquinone and Menaquinones, and can maintain bone health by acting on proteins expressed in osteoblasts.
Vitamin K is principally known because it is involved in blood coagulation. Furthermore, epidemiological studies showed that its deficit was associated with increased fragility fractures, vascular calcification and mortality. There are two main types of vitamin K vitamers: Phylloquinone (or PK) and Menaquinones (MKn). Vitamin K acts both as coenzyme of y-glutamyl carboxylase (GGCX) transforming undercarboxylated in carboxylated vitamin K-dependent proteins (e.g., Osteocalcin and Matrix Gla Protein) and as a ligand of the nuclear steroid and xenobiotic receptor (SXR) (in murine species Pregnane X Receptor: PXR), expressed in osteoblasts. It has been highlighted that the uremic state is a condition of greater vitamin K deficiency than the general population with resulting higher prevalence of bone fractures, vascular calcifications and mortality. The purpose of this literature review is to evaluate the protective role of Vitamin K in bone health in CKD patients.
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