K2’s Vital Role in Regressing Soft Tissue Calcification in Dialysis Patients
Coronary artery calcification (CAC) is much more prevalent in patients with end-stage renal disease (ESRD), and cardiovascular disease (CVD) is the leading cause of mortality in this population. A new review paper published in BioMed Research International examines the current strategy and treatments for vascular calcification in chronic kidney disease (CKD) patients.1
Scientific data shows that ones vascular calcification occurs, it is unlikely to be reserved. Any therapeutic interventions that stop and regress the “calcium paradox” may be invaluable to patients with ESRD suffering from vascular disease.
While no definite therapy has emerged so far, it has been demonstrated that since vitamin K is involved in the activation of vitamin K dependent proteins such as matrix Gla protein (MGP), which is a strong inhibitor of soft tissue calcification, thus deficiency of this nutrient increases the risk of bone fracture and vascular calcification. Correction of vitamin D and vitamin K deficiency was described as one of the strategies, which can be helpful for patients with kidney problems who remain on chronic dialysis. The authors mentioned only one clinical study, where a subgroup analysis of participants who were ≥85% adherent to a 500 µg daily vitamin K1 treatment showed a lower CAC progression in the phylloquinone group than in the controls.
Dr. Katarzyna Maresz, president of the International Science and Health Foundation, points to the fact that vitamin K2 was scientifically proven to be more bioefficient in the activation of vitamin K dependent proteins than vitamin K1. “Caluwé et al (2014) reported that 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”, she emphasizes. “Moreover, Kurnatowska et al study (2015) demonstrated that supplementation with vitamin K2 (MK-7) and vitaminD3 is beneficial in CKD patients. Kurnatowska et al found that a 270-day course of 90 µg vitamin K2 administration may reduce the progression of atherosclerosis, and vitamin K2 significantly changed the pattern of promoters and calcification inhibitors,” Dr. Maresz adds.
In summary, vitamin K2 supplementation may be a simple means to prevent the progression of accelerated vascular calcification in hemodialysis patients, a population characterized by severe functional vitamin K deficiency. Hopefully, the existing CAC in dialysis patients in current trials will be reduced.
- Nai-Ching Chen, Chih-Yang Hsu, and Chien-Liang Chen, “The Strategy to Prevent and Rgress the Vascular Calcification in Dialysis Patients”, BioMed Research International, vol. 2017, Article ID 9035193, 11 pages, 2017. doi: 10.1155/2017/9035193
- Rogier Caluwé, Stefaan Vandecasteele, Bruno Van Vlem, Cees Vermeer, As S. Vriese; Vitamin K2 supplementation in heamodialysis patients: a randomized dose-finding-study. Nephrol Dial Transplant 2014; 29 (7): 1385-13-90. doi: 10.2093/ndt/gft464
- Kurnatowska I, Grzelak P, Masajtis Zagajewska A, Kaczmarska M, Stefańczyk L, Vermeer C, Maresz K, Nowicki M. Effect of vitamin K2 on progression of atherosclerosis and vascular calcification in nondialyzed patients with chronic kidney disease stage 35. Pol Arch Med Wewn. 2015 Jul 15. pii: AOP_15_066. [Epub ahead of print]