Vitamin K intake and status are low in hemodialysis patients

Kidney Int. 2012 Sep;82(5):605-10. doi: 10.1038/ki.2012.191. Epub 2012 May 30.


Vitamin K is essential for the activity of γ-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 K(1) and K(2) intake (4-day food record), and the vitamin K status in 40 hemodialysis patients. The intake was low in these patients (median 140 μg/day), especially on days of dialysis and the weekend as compared to intakes reported in a reference population of healthy adults (mean K(1) and K(2) intake 200 μg/day and 31 μg/day, respectively). Non-carboxylated bone and coagulation proteins were found to be elevated in 33 hemodialysis patients, indicating subclinical hepatic vitamin K deficiency. Additionally, very high non-carboxylated 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • Calcium-Binding Proteins / blood
  • Diet
  • Dietary Supplements
  • Extracellular Matrix Proteins / blood
  • Female
  • Humans
  • Liver / metabolism
  • Male
  • Matrix Gla Protein
  • Middle Aged
  • Netherlands
  • Nutrition Policy
  • Nutritional Status*
  • Osteocalcin / blood
  • Protein Precursors / blood
  • Prothrombin
  • Renal Dialysis*
  • Vitamin K 1 / administration & dosage
  • Vitamin K 1 / blood*
  • Vitamin K 2 / administration & dosage
  • Vitamin K 2 / blood*
  • Vitamin K Deficiency / blood*
  • Young Adult


  • Biomarkers
  • Calcium-Binding Proteins
  • Extracellular Matrix Proteins
  • Protein Precursors
  • Osteocalcin
  • Vitamin K 2
  • acarboxyprothrombin
  • Vitamin K 1
  • Prothrombin