期刊
KIDNEY INTERNATIONAL
卷 82, 期 5, 页码 605-610出版社
ELSEVIER SCIENCE INC
DOI: 10.1038/ki.2012.191
关键词
hemodialysis hazard; mineral metabolism; nutrition; target organ damage; vascular calcification
资金
- Netherlands Heart Foundation [2008T062]
Vitamin K is essential for the activity of gamma-carboxyglutamate (Gla)-proteins including matrix Gla28 protein and osteocalcin; an inhibitor of vascular calcification and a bone matrix protein, respectively. Insufficient vitamin K intake leads to the production of non-carboxylated, inactive proteins and this could contribute to the high risk of vascular calcification in hemodialysis patients. To help resolve this, we measured vitamin K-1 and K-2 intake (4-day food record), and the vitamin K status in 40 hemodialysis patients. The intake was low in these patients (median 140 mu g/day), especially on days of dialysis and the weekend as compared to intakes reported in a reference population of healthy adults (mean K1 and K-2 intake 200 mu g/day and 31 mu g/day, respectively). Non-carboxylated bone and coagulation proteins were found to be elevated in 33 hemodialysis patients, indicating subclinical hepatic vitamin K deficiency. Additionally, very high non-carboxylated matrix Gla28 protein levels, endemic to all patients, suggest vascular vitamin K deficiency. Thus, compared to healthy individuals, hemodialysis patients have a poor overall vitamin K status due to low intake. A randomized controlled trial is needed to test whether vitamin K supplementation reduces the risk of arterial calcification and mortality in hemodialysis patients.
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