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Vitamin K for the Treatment of Cardiovascular Disease in End-Stage Renal Disease Patients: Is there Hope?
Curr Vasc Pharmacol. 2021; 19(1):77-90.CV

Abstract

In Chronic Kidney Disease, vascular calcification (VC) is highly prevalent even at early stages and is gradually enhanced, along with disease progression to End-Stage Renal Disease (ESRD). The calcification pattern in uremia includes all types of mineralization and contributes to the heavy cardiovascular (CV) burden that is common in these patients. Ectopic mineralization is the result of the imbalance between inhibitors and promoters of vascular calcification, with the latter overwhelming the former. The most powerful, natural inhibitor of calcification is Matrix Gla Protein (MGP), a small vitamin K dependent protein, secreted by chondrocytes and vascular smooth muscle cells. In uremia, MGP was reported as the only molecule able to reverse VC by "sweeping" calcium and hydroxyapatite crystals away from the arterial wall. To become biologically active, this protein needs to undergo carboxylation and phosphorylation, reactions highly dependent on vitamin K status. The inactive form of MGP reflects the deficiency of vitamin K and has been associated with CV events and mortality in ESRD patients. During the past decade, vitamin K status has emerged as a novel risk factor for vascular calcification and CV disease in various populations, including dialysis patients. This review presents evidence regarding the association between vitamin K and CV disease in ESRD patients, which are prone to atherosclerosis and atheromatosis.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Roumeliotis S
Division of Nephrology and Hypertension, 1st Department of Internal Medicine, AHEPA Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Roumeliotis A
Division of Nephrology and Hypertension, 1st Department of Internal Medicine, AHEPA Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Dounousi E
Department of Nephrology, Medical School, University Hospital of Ioannina, Ioannina, Greece.
Eleftheriadis T
Department of Nephrology, Medical School, University of Thessaly, Larissa, Greece.
Liakopoulos V
Division of Nephrology and Hypertension, 1st Department of Internal Medicine, AHEPA Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.

MeSH

AnimalsBlood VesselsCalcium-Binding ProteinsExtracellular Matrix ProteinsHumansKidney Failure, ChronicRisk FactorsSignal TransductionTreatment OutcomeVascular CalcificationVitamin KVitamin K Deficiency

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

32196451

Clinical Trial Links

The Effect of Vitamin K2 Supplementation on Arterial Stifness and Cardiovascular Events in PEritonial DIAlysis

Citation

Roumeliotis, Stefanos, et al. "Vitamin K for the Treatment of Cardiovascular Disease in End-Stage Renal Disease Patients: Is There Hope?" Current Vascular Pharmacology, vol. 19, no. 1, 2021, pp. 77-90.
Roumeliotis S, Roumeliotis A, Dounousi E, et al. Vitamin K for the Treatment of Cardiovascular Disease in End-Stage Renal Disease Patients: Is there Hope? Curr Vasc Pharmacol. 2021;19(1):77-90.
Roumeliotis, S., Roumeliotis, A., Dounousi, E., Eleftheriadis, T., & Liakopoulos, V. (2021). Vitamin K for the Treatment of Cardiovascular Disease in End-Stage Renal Disease Patients: Is there Hope? Current Vascular Pharmacology, 19(1), 77-90. https://doi.org/10.2174/1570161118666200320111745
Roumeliotis S, et al. Vitamin K for the Treatment of Cardiovascular Disease in End-Stage Renal Disease Patients: Is There Hope. Curr Vasc Pharmacol. 2021;19(1):77-90. PubMed PMID: 32196451.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vitamin K for the Treatment of Cardiovascular Disease in End-Stage Renal Disease Patients: Is there Hope? AU - Roumeliotis,Stefanos, AU - Roumeliotis,Athanasios, AU - Dounousi,Evangelia, AU - Eleftheriadis,Theodoros, AU - Liakopoulos,Vassilios, PY - 2019/11/24/received PY - 2020/02/24/revised PY - 2020/02/25/accepted PY - 2020/3/21/pubmed PY - 2021/6/8/medline PY - 2020/3/21/entrez KW - Cardiovascular disease KW - chronic kidney disease KW - end-stage renal disease KW - hemodialysis KW - matrix gla protein KW - vascular calcification KW - vitamin K SP - 77 EP - 90 JF - Current vascular pharmacology JO - Curr Vasc Pharmacol VL - 19 IS - 1 N2 - In Chronic Kidney Disease, vascular calcification (VC) is highly prevalent even at early stages and is gradually enhanced, along with disease progression to End-Stage Renal Disease (ESRD). The calcification pattern in uremia includes all types of mineralization and contributes to the heavy cardiovascular (CV) burden that is common in these patients. Ectopic mineralization is the result of the imbalance between inhibitors and promoters of vascular calcification, with the latter overwhelming the former. The most powerful, natural inhibitor of calcification is Matrix Gla Protein (MGP), a small vitamin K dependent protein, secreted by chondrocytes and vascular smooth muscle cells. In uremia, MGP was reported as the only molecule able to reverse VC by "sweeping" calcium and hydroxyapatite crystals away from the arterial wall. To become biologically active, this protein needs to undergo carboxylation and phosphorylation, reactions highly dependent on vitamin K status. The inactive form of MGP reflects the deficiency of vitamin K and has been associated with CV events and mortality in ESRD patients. During the past decade, vitamin K status has emerged as a novel risk factor for vascular calcification and CV disease in various populations, including dialysis patients. This review presents evidence regarding the association between vitamin K and CV disease in ESRD patients, which are prone to atherosclerosis and atheromatosis. SN - 1875-6212 UR - https://www.unboundmedicine.com/medline/citation/32196451/Vitamin_K_for_the_Treatment_of_Cardiovascular_Disease_in_End_Stage_Renal_Disease_Patients:_Is_there_Hope DB - PRIME DP - Unbound Medicine ER -