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Titolo Vitamin K intake and status are low in hemodialysis patients
Autore Ellen C.M. Cranenburg1, Leon J. Schurgers2, Herma H. Uiterwijk3, Joline W.J. Beulens4, Gerdien W. Dalmeijer4, Ralf Westerhuis3, Elke J. Magdeleyns1, Marjolein Herfs1, Cees Vermeer1 and Gozewijn D. Laverman3,5 1VitaK and Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands; 2Department of Biochemistry, Maastricht University, Maastricht, The Netherlands; 3Dialysis Center Groningen, Groningen, The Netherlands; 4Julius - Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands and 5Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, Groningen, The Netherlands
Referenza Kidney International 2012; 82: 605-610

Vitamin K is essential for the activity of c-carboxyglutamate (Gla)-proteins including matrix Gla28 protein and osteocalcin; an inhibitor of vascular calcification and a bone matrix protein, respectively. Insufficient vitamin K intake leads to the production of non-carboxylated, inactive proteins and this could contribute to the high risk of vascular calcification in hemodialysis patients. To help resolve this, we measured vitamin K1 and K2 intake (4-day food record), and the vitamin K status in 40 hemodialysis patients. The intake was low in these patients (median 140 lg/day), especially on days of dialysis and the weekend as compared to intakes reported in a reference population of healthy adults (mean K1 and K2 intake 200 lg/day and 31 lg/day, respectively). Noncarboxylated bone and coagulation proteins were found to be elevated in 33 hemodialysis patients, indicating subclinical hepatic vitamin K deficiency. Additionally, very high noncarboxylated matrix Gla28 protein levels, endemic to all patients, suggest vascular vitamin K deficiency. Thus, compared to healthy individuals, hemodialysis patients have a poor overall vitamin K status due to low intake. A randomized controlled trial is needed to test whether vitamin K supplementation reduces the risk of arterial calcification and mortality in hemodialysis patients.

Data 15.03.2013
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