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Vitamin K2 supplementation in haemodialysis patients: a randomized dose-finding study.
Nephrol Dial Transplant. 2014 Jul; 29(7):1385-90.ND

Abstract

BACKGROUND

Haemodialysis patients suffer from accelerated vascular calcification. The vitamin K-dependent matrix Gla protein (MGP) is one of the most powerful inhibitors of vascular calcification. Haemodialysis patients have high levels of the inactive form of MGP (desphosphorylated-uncarboxylated-MGP, dp-uc-MGP) and may benefit from pharmacological doses of vitamin K2 (menaquinone) to improve the calcification inhibitory activity of MGP.

METHODS

To determine the optimal dose of menaquinone-7 (MK-7) for MGP activation, 200 chronic haemodialysis patients were recruited to randomly receive 360, 720 or 1080 µg of MK-7 thrice weekly for 8 weeks. Dp-uc-MGP was measured at baseline and after 8 weeks. Dietary intake of vitamin K1 (phylloquinone) and menaquinone was estimated based on a detailed questionnaire.

RESULTS

At baseline, dp-uc-MGP was not associated with phylloquinone intake (P = 0.92), but correlated inversely with menaquinone intake (P = 0.023). MK-7 supplementation dose dependently reduced dp-uc-MGP. The levels decreased by 17, 33 and 46% in the respective groups. Drop-outs were mainly due to gastrointestinal side-effects related to the unpleasant smell of the tablets.

CONCLUSIONS

Chronic haemodialysis patients have high levels of inactive MGP, possibly related to a low dietary vitamin K intake. Pharmacological doses of MK-7 dose-dependently reduce dp-uc-MGP. Menaquinone supplementation may be a novel approach to prevent vascular calcifications in chronic haemodialysis patients.

Authors+Show Affiliations

Division of Nephrology, OLV Hospital, Aalst, Belgium.Division of Nephrology and Infectious Diseases, AZ St.-Jan Hospital, Brugge, Belgium.Division of Nephrology, OLV Hospital, Aalst, Belgium.VitaK, Maastricht University, EV Maastricht, the Netherlands.Division of Nephrology and Infectious Diseases, AZ St.-Jan Hospital, Brugge, Belgium.

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

24285428

Citation

Caluwé, Rogier, et al. "Vitamin K2 Supplementation in Haemodialysis Patients: a Randomized Dose-finding Study." Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, vol. 29, no. 7, 2014, pp. 1385-90.
Caluwé R, Vandecasteele S, Van Vlem B, et al. Vitamin K2 supplementation in haemodialysis patients: a randomized dose-finding study. Nephrol Dial Transplant. 2014;29(7):1385-90.
Caluwé, R., Vandecasteele, S., Van Vlem, B., Vermeer, C., & De Vriese, A. S. (2014). Vitamin K2 supplementation in haemodialysis patients: a randomized dose-finding study. Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, 29(7), 1385-90. https://doi.org/10.1093/ndt/gft464
Caluwé R, et al. Vitamin K2 Supplementation in Haemodialysis Patients: a Randomized Dose-finding Study. Nephrol Dial Transplant. 2014;29(7):1385-90. PubMed PMID: 24285428.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vitamin K2 supplementation in haemodialysis patients: a randomized dose-finding study. AU - Caluwé,Rogier, AU - Vandecasteele,Stefaan, AU - Van Vlem,Bruno, AU - Vermeer,Cees, AU - De Vriese,An S, Y1 - 2013/11/26/ PY - 2013/11/29/entrez PY - 2013/11/29/pubmed PY - 2014/9/24/medline KW - haemodialysis KW - menaquinone KW - vascular calcification SP - 1385 EP - 90 JF - Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association JO - Nephrol Dial Transplant VL - 29 IS - 7 N2 - BACKGROUND: Haemodialysis patients suffer from accelerated vascular calcification. The vitamin K-dependent matrix Gla protein (MGP) is one of the most powerful inhibitors of vascular calcification. Haemodialysis patients have high levels of the inactive form of MGP (desphosphorylated-uncarboxylated-MGP, dp-uc-MGP) and may benefit from pharmacological doses of vitamin K2 (menaquinone) to improve the calcification inhibitory activity of MGP. METHODS: To determine the optimal dose of menaquinone-7 (MK-7) for MGP activation, 200 chronic haemodialysis patients were recruited to randomly receive 360, 720 or 1080 µg of MK-7 thrice weekly for 8 weeks. Dp-uc-MGP was measured at baseline and after 8 weeks. Dietary intake of vitamin K1 (phylloquinone) and menaquinone was estimated based on a detailed questionnaire. RESULTS: At baseline, dp-uc-MGP was not associated with phylloquinone intake (P = 0.92), but correlated inversely with menaquinone intake (P = 0.023). MK-7 supplementation dose dependently reduced dp-uc-MGP. The levels decreased by 17, 33 and 46% in the respective groups. Drop-outs were mainly due to gastrointestinal side-effects related to the unpleasant smell of the tablets. CONCLUSIONS: Chronic haemodialysis patients have high levels of inactive MGP, possibly related to a low dietary vitamin K intake. Pharmacological doses of MK-7 dose-dependently reduce dp-uc-MGP. Menaquinone supplementation may be a novel approach to prevent vascular calcifications in chronic haemodialysis patients. SN - 1460-2385 UR - https://www.unboundmedicine.com/medline/citation/24285428/Vitamin_K2_supplementation_in_haemodialysis_patients:_a_randomized_dose_finding_study_ L2 - https://academic.oup.com/ndt/article-lookup/doi/10.1093/ndt/gft464 DB - PRIME DP - Unbound Medicine ER -