The effect of vitamin K2 supplementation on vascular calcification in haemodialysis patients: a 1-year follow-up randomized trial

Int Urol Nephrol. 2019 Nov;51(11):2037-2044. doi: 10.1007/s11255-019-02275-2. Epub 2019 Sep 17.

Abstract

Purpose: Vascular calcification (VC) is an independent risk factor for cardiovascular disease in hemodialysis patients while Matrix GLA protein (MGP) is one of the most potent inhibitors of VC and its activation is vitamin K dependent. The aim of this study is to investigate the role of oral vitamin K2 supplementation in the prevention of VC progression in haemodialysis patients.

Methods: We conducted a prospective randomized interventional study in patients on hemodialysis. Patients were randomly assigned to either receiving orally 200 μgr of vitamin K2 (vitamin K2/MK-7, Solgar) every day for 1 year or no treatment. Uncarboxylated MGP (uc-MGP) concentrations were quantified using ELISA at randomization, at 3 and at 12 months. Aortic calcification was evaluated using Agatston score after an abdominal computed tomography scan that was performed at the beginning and at 12 months of follow-up.

Results: There were 102 patients that were randomized. After 1 year of follow-up, 22 patients from the vitamin K2 group and 30 patients from the control group were included in the analysis. After 3 months of treatment, uc-MGP values remained unchanged in the vitK2 group but after 1 year were reduced by 47% (p = 0.005). Furthermore, uc-MGP at 1 year was increased by 12% in the control group. At 1 year, vitK2 group had significantly lower values of uc-MGP in comparison to controls (p = 0.03). Agatston score was increased significantly both in vitamin K2 and control group at 1 year with no difference between groups.

Conclusions: Oral administration of vitamin K2 in patients on haemodialysis reduced serum uc-MGP levels but did not have an effect in the progression of aortic calcification.

Keywords: Chronic kidney disease; Hemodialysis; Vascular calcification; Vitamin K2.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Calcium-Binding Proteins / blood
  • Dietary Supplements*
  • Disease Progression
  • Extracellular Matrix Proteins / blood
  • Follow-Up Studies
  • Humans
  • Kidney Failure, Chronic / complications
  • Kidney Failure, Chronic / therapy*
  • Middle Aged
  • Prospective Studies
  • Renal Dialysis*
  • Time Factors
  • Vascular Calcification / blood
  • Vascular Calcification / etiology
  • Vascular Calcification / prevention & control*
  • Vitamin K 2 / therapeutic use*
  • Vitamins / therapeutic use*

Substances

  • Calcium-Binding Proteins
  • Extracellular Matrix Proteins
  • Vitamins
  • matrix Gla protein
  • Vitamin K 2