Supplementary nutrients for prevention of vascular calcification in patients with chronic kidney disease (Lee SM and An WS)

A review paper published recently in The Korean Journal of Internal Medicine focuses on the ability of supplementary nutrients to prevent vascular calcification (VC) in patients with chronic kidney disease (CKD), in whom dietary restriction is essential.

As compared to the general population, patients with chronic kidney disease are at greater risk of cardiovascular disease (CVD). Epidemiologic findings presented by the authors show that vascular calcification associated with CVD is commonly found in patients with CKD who are on dialysis. Aging of aorta and coronary artery is reflected by VC of these vessels. It is also encountered in elderly persons without CKD. Malnutrition is related to CVD and is frequently found in patients with advanced CKD and even in non-CKD elderly population. A low- or very-low-protein diet that is usually recommended for CKD patients may cause malnutrition and deficiency of important nutrients, such as vitamins K and D.

“Mechanisms by which vitamin D, vitamin K2, and omega-3 fatty acids modulate arterial intimal and medial calcification in patients with CKD are presented in a very reader-friendly way in this review,” says Dr. Katarzyna Maresz, president of the International Science and Health Foundation. She feels the authors mentioned a crucial fact, namely that vitamin K2 and D deficiency are important issues in the kidney category of patients: “Menaquinone-7, a type of vitamin K2, is under investigation for inhibiting VC in elderly patients without CKD, as well as for prevention of VC in patients with CKD”. According to Dr. Maresz the bottom line of their article: “Nutritional management, such as a VLPD, may be necessary to delay the progression of renal disease; however, deficiencies in essential nutrients, such vitamins K2 and D, must be overcome to prevent VC. Cholecalciferol, MK [vitamin K2], and omega-3 FA are promising supplementary nutrients for preventing VC in patients with CKD” is a milestone in chronic kidney disease treatment, in Korea and elsewhere.

References:

Lee SM, An WS (2019) Supplementary nutrients for prevention of vascular calcification in patients with chronic kidney disease, Korean J Intern Med 34(3):459-469, doi: 10.3904/kjim.2019.125

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