The Strategy to Prevent and Regress the Vascular Calcification in Dialysis Patients (Chen et al.)
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
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. Scientific data shows that vascular calcification, once it occurs, is unlikely to be reserved. No definite therapy has emerged so far. Any therapeutic interventions that stop and regress the “calcium paradox” may be invaluable to patients with ESRD suffering from vascular disease.
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. Although, vitamin D deficiency is recognized by medical society, vitamin K treatment seems to be rather new. Vitamin K is involved in the activation of vitamin K dependent proteins such as matrix Gla protein (MGP), a strong inhibitor of soft tissue calcification. It has been demonstrated that vitamin K deficiency increases the risk of bone fracture and vascular calcification. 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 out the fact that vitamin K2 was scientifically proven to be more bioefficient in the activation of vitamin K dependent proteins than vitamin K1. “Calluwe et al (2014) reported that haemodialysis patients have high levels of the inactive form of MGP (desphosphorylated-uncarboxylated-MGP, dp-uc-MGP) and may benefot form pharmacological doses of vitamin K2 (menaquinone) to improve the calcification inhibitory activity of MGP2″, she emphasizes. “Moreover, Kurtanowska et al study (2015) demontrated that supplementation with vitamin K2 (MK-7) and vitamin D3 is beneficial in CKD patients.3 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.”
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, nad Chien-Liang Chen, “The Strategy to Prevent and Regress 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. De Vriese; Vitamin K2 supplementation in haemodialysis patients: a randomized dose-finding study. Nephrol Dial Transplant (7): 1385-1390. doi: 10.1093/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]