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Functional deficiency of vitamin K in hemodialysis patients in Upper Silesia in Poland.
Int Urol Nephrol 2016; 48(5):765-71IU

Abstract

PURPOSE

Functional vitamin K deficiency (both K1 and K2) is postulated to be one of the most relevant links between chronic kidney disease and vascular calcification in hemodialysis (HD) patients. Recommended dietary restrictions in HD patients superimposed on diversity of eating habits across the countries may affect the prevalence of functional vitamin K deficiency. The aim of this study was to determine the level of functional vitamin K deficiency and its relation to vitamin K1 intake in HD patients in Upper Silesia in Poland.

METHODS

Protein-induced vitamin K absence or antagonist-II (PIVKA-II) and undercarboxylated matrix Gla protein (ucMGP) were assessed by ELISA in 153 stable, prevalent HD patients and 20 apparently healthy adults (to establish normal ranges for PIVKA-II and ucMGP). Daily phylloquinone intake was assessed using a food frequency questionnaire.

RESULTS

PIVKA-II and ucMGP levels were increased in 27.5 and 77.1 % of HD patients in comparison with the reference ranges in apparently healthy controls, respectively. In 45 % of cases, the increased PIVKA-II level was explained by insufficient phylloquinone intake for Polish population (recommended intake: >55 μg for women and >65 µg for men). Applying ROC analysis, we showed that vitamin K1 intake below 40.2 µg/day was associated with increased PIVKA-II levels. There was no correlation between vitamin K1 intake and plasma concentration of ucMGP, or between PIVKA-II and ucMGP.

CONCLUSIONS

(1) Functional vitamin K1 deficiency is explained by low vitamin K1 intake in less than half of HD patients. (2) Undercarboxylated matrix Gla protein level is a poor surrogate for functional vitamin K1 deficiency.

Authors+Show Affiliations

Health Promotion and Obesity Management Unit, Department of Pathophysiology, Medical Faculty in Katowice, Medical University of Silesia, Medyków 18, 40-752, Katowice, Poland.Department of Pathophysiology, Medical Faculty in Katowice, Medical University of Silesia, Medyków 18 Street, 40-752, Katowice, Poland. Department of Internal, Autoimmune and Metabolic Diseases, Medical Faculty in Katowice, Medical University of Silesia, Medyków 14, 40-752, Katowice, Poland.Dialysis Center in Rybnik, Regional Specialist Hospital No. 3, Energetyków 46, 44-200, Rybnik, Poland.Dialysis Center in Tychy, Centrum Dializa Sosnowiec, Narcyzów 24, 43-100, Tychy, Poland. Dialysis Center in Pszczyna, Centrum Dializa Sosnowiec, Antesa 11, 43-200, Pszczyna, Poland.Dialysis Center in Siemianowice Śląskie, Nefrolux, Szpitalna 6, 41-100, Siemianowice Śląskie, Poland.Department of Nephrology, Transplantation and Internal Medicine, Medical Faculty in Katowice, Medical University of Silesia, Francuska 20-24, 40-027, Katowice, Poland.Dialysis Center in Katowice, Centrum Dializa Sosnowiec, Medyków 17, 40-752, Katowice, Poland.Dialysis Center in Chorzów, Centrum Dializa Sosnowiec, Strzelców Bytomskich 11, 41-500, Chorzów, Poland.Dialysis Center in Żory, Centrum Dializa Sosnowiec, Dąbrowskiego 20, 44-241, Żory, Poland. Dialysis Center in Wodzisław Śląski, Centrum Dializa Sosnowiec, Leszka 10, 44-313, Wodzisław Śląski, Poland.Dialysis Center in Sosnowiec, Centrum Dializa Sosnowiec, Jabłoniowa 27, 41-200, Sosnowiec, Poland.Health Promotion and Obesity Management Unit, Department of Pathophysiology, Medical Faculty in Katowice, Medical University of Silesia, Medyków 18, 40-752, Katowice, Poland.Department of Nephrology, Transplantation and Internal Medicine, Medical Faculty in Katowice, Medical University of Silesia, Francuska 20-24, 40-027, Katowice, Poland.Department of Pathophysiology, Medical Faculty in Katowice, Medical University of Silesia, Medyków 18 Street, 40-752, Katowice, Poland. chj@poczta.fm.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

27000106

Citation

Wyskida, Katarzyna, et al. "Functional Deficiency of Vitamin K in Hemodialysis Patients in Upper Silesia in Poland." International Urology and Nephrology, vol. 48, no. 5, 2016, pp. 765-71.
Wyskida K, Żak-Gołąb A, Wajda J, et al. Functional deficiency of vitamin K in hemodialysis patients in Upper Silesia in Poland. Int Urol Nephrol. 2016;48(5):765-71.
Wyskida, K., Żak-Gołąb, A., Wajda, J., Klein, D., Witkowicz, J., Ficek, R., ... Chudek, J. (2016). Functional deficiency of vitamin K in hemodialysis patients in Upper Silesia in Poland. International Urology and Nephrology, 48(5), pp. 765-71. doi:10.1007/s11255-016-1255-6.
Wyskida K, et al. Functional Deficiency of Vitamin K in Hemodialysis Patients in Upper Silesia in Poland. Int Urol Nephrol. 2016;48(5):765-71. PubMed PMID: 27000106.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Functional deficiency of vitamin K in hemodialysis patients in Upper Silesia in Poland. AU - Wyskida,Katarzyna, AU - Żak-Gołąb,Agnieszka, AU - Wajda,Jarosław, AU - Klein,Dariusz, AU - Witkowicz,Joanna, AU - Ficek,Rafał, AU - Rotkegel,Sylwia, AU - Spiechowicz,Urszula, AU - Kocemba Dyczek,Joanna, AU - Ciepał,Jarosław, AU - Olszanecka-Glinianowicz,Magdalena, AU - Więcek,Andrzej, AU - Chudek,Jerzy, Y1 - 2016/03/21/ PY - 2015/12/17/received PY - 2016/02/24/accepted PY - 2016/3/23/entrez PY - 2016/3/24/pubmed PY - 2017/1/20/medline KW - Hemodialysis KW - Nutrition KW - PIVKA-II KW - Undercarboxylated MGP KW - Vitamin K intake SP - 765 EP - 71 JF - International urology and nephrology JO - Int Urol Nephrol VL - 48 IS - 5 N2 - PURPOSE: Functional vitamin K deficiency (both K1 and K2) is postulated to be one of the most relevant links between chronic kidney disease and vascular calcification in hemodialysis (HD) patients. Recommended dietary restrictions in HD patients superimposed on diversity of eating habits across the countries may affect the prevalence of functional vitamin K deficiency. The aim of this study was to determine the level of functional vitamin K deficiency and its relation to vitamin K1 intake in HD patients in Upper Silesia in Poland. METHODS: Protein-induced vitamin K absence or antagonist-II (PIVKA-II) and undercarboxylated matrix Gla protein (ucMGP) were assessed by ELISA in 153 stable, prevalent HD patients and 20 apparently healthy adults (to establish normal ranges for PIVKA-II and ucMGP). Daily phylloquinone intake was assessed using a food frequency questionnaire. RESULTS: PIVKA-II and ucMGP levels were increased in 27.5 and 77.1 % of HD patients in comparison with the reference ranges in apparently healthy controls, respectively. In 45 % of cases, the increased PIVKA-II level was explained by insufficient phylloquinone intake for Polish population (recommended intake: >55 μg for women and >65 µg for men). Applying ROC analysis, we showed that vitamin K1 intake below 40.2 µg/day was associated with increased PIVKA-II levels. There was no correlation between vitamin K1 intake and plasma concentration of ucMGP, or between PIVKA-II and ucMGP. CONCLUSIONS: (1) Functional vitamin K1 deficiency is explained by low vitamin K1 intake in less than half of HD patients. (2) Undercarboxylated matrix Gla protein level is a poor surrogate for functional vitamin K1 deficiency. SN - 1573-2584 UR - https://www.unboundmedicine.com/medline/citation/27000106/Functional_deficiency_of_vitamin_K_in_hemodialysis_patients_in_Upper_Silesia_in_Poland_ L2 - https://doi.org/10.1007/s11255-016-1255-6 DB - PRIME DP - Unbound Medicine ER -