scholarly journals Vitamin K and D Supplementation and Bone Health in Chronic Kidney Disease—Apart or Together?

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 809
Author(s):  
Marta Ziemińska ◽  
Beata Sieklucka ◽  
Krystyna Pawlak
Keyword(s):  
Chronic Kidney Disease ◽  
Vitamin D ◽  
Kidney Disease ◽  
Vitamin K ◽  
Bone Health ◽  
Clinical Evidence ◽  
Mechanisms Of Action ◽  
Preclinical Studies ◽  
Normal Bone ◽  
Combined Supplementation

Vitamin K (VK) and vitamin D (VD) deficiency/insufficiency is a common feature of chronic kidney disease (CKD), leading to impaired bone quality and a higher risk of fractures. CKD patients, with disturbances in VK and VD metabolism, do not have sufficient levels of these vitamins for maintaining normal bone formation and mineralization. So far, there has been no consensus on what serum VK and VD levels can be considered sufficient in this particular population. Moreover, there are no clear guidelines how supplementation of these vitamins should be carried out in the course of CKD. Based on the existing results of preclinical studies and clinical evidence, this review intends to discuss the effect of VK and VD on bone remodeling in CKD. Although the mechanisms of action and the effects of these vitamins on bone are distinct, we try to find evidence for synergy between them in relation to bone metabolism, to answer the question of whether combined supplementation of VK and VD will be more beneficial for bone health in the CKD population than administering each of these vitamins separately.

scholarly journals Emerging Role of Vitamins D and K in Modulating Uremic Vascular Calcification: The Aspect of Passive Calcification

Nutrients ◽  
2019 ◽  
Vol 11 (1) ◽  
pp. 152 ◽  
Author(s):  
Yi-Chou Hou ◽  
Chien-Lin Lu ◽  
Cai-Mei Zheng ◽  
Ruei-Ming Chen ◽  
Yuh-Feng Lin ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Vitamin D ◽  
Kidney Disease ◽  
Vascular Calcification ◽  
Vitamin K ◽  
Matrix Vesicles ◽  
Vital Role ◽  
Matrix Gla Protein ◽  
Protein Receptor ◽  
Calciprotein Particles

Vascular calcification is a critical complication in patients with chronic kidney disease (CKD) because it is predictive of cardiovascular events and mortality. In addition to the traditional mechanisms associated with endothelial dysfunction and the osteoblastic transformation of vascular smooth muscle cells (VSMCs), the regulation of calcification inhibitors, such as calciprotein particles (CPPs) and matrix vesicles plays a vital role in uremic vascular calcification in CKD patients because of the high prevalence of vitamin K deficiency. Vitamin K governs the gamma-carboxylation of matrix Gla protein (MGP) for inhibiting vascular calcification, and the vitamin D binding protein receptor is related to vitamin K gene expression. For patients with chronic kidney disease, adequate use of vitamin D supplements may play a role in vascular calcification through modulation of the calciprotein particles and matrix vesicles (MVs).

CKD-MBD und sekundärer Hyperparathyreoidismus (Teil 1)

2021 ◽  
Vol 25 (10) ◽  
pp. 403-409
Author(s):  
Markus Ketteler ◽  
Kai Hahn
Keyword(s):  
Chronic Kidney Disease ◽  
Vitamin D ◽  
Kidney Disease ◽  
Vitamin K ◽  
Vitamin K2 ◽  
Sekundärer Hyperparathyreoidismus ◽  
Mineral Bone Disorder ◽  
Bone Disorder

ZUSAMMENFASSUNGDer Begriff CKD-MBD (Chronic Kidney Disease – Mineral Bone Disorder) ist seit einigen Jahren für Störungen des Kalzium-Phosphat-Stoffwechsels und der damit verbundenen Risiken für das Mineral-Knochen- und Herz-Kreislauf-System bei chronischen Nierenerkrankungen bekannt. Die Bezeichnung entstand nach einem Paradigmenwechsel in der Pathophysiologie des sekundären Hyperparathyreoidismus und da neue Akteure wie FGF23 und Klotho gefunden wurden, die eine wichtige Rolle bei der Entstehung der Störungen spielen. Das wachsende Verständnis der Zusammenhänge zwischen den neuen Akteuren und Kalzium, Phosphat, Vitamin D und Vitamin K2 und der Verkalkung von Gefäßen und Weichteilen beeinflusste unweigerlich unsere Therapien. Dieser erste Teil des Beitrags verschafft einen Überblick über die neuesten Erkenntnisse zum Phosphat-Sensing, die Rolle von FGF23 und Klotho und die Besonderheiten des Vitamin-D- und Vitamin-K-Stoffwechsels bei Gesundheit und chronischer Nierenerkrankung.

scholarly journals Pharmacotherapy in chronic kidney disease hyperphosphatemia – effects on vascular calcification and bone health

2017 ◽  
Vol 63 (01) ◽  
pp. 3-24
Author(s):  
Dimce Dzingarski ◽  
Kristina Mladenovska
Keyword(s):  
Chronic Kidney Disease ◽  
Vitamin D ◽  
Kidney Disease ◽  
Bone Health ◽  
Mineral Metabolism ◽  
Phosphate Binders ◽  
Active Vitamin ◽  
Bone Disorders ◽  
Active Vitamin D ◽  
Active Vitamin D Sterols

Hyperphosphatemia (HP) in patients with chronic kidney disease (CKD) leads to complications such as renal osteodistrophy, cardiovascular calcification and hemodynamic abnormalities, all of them having a serious impact on the survival rate and quality of life. Also, HP is a key pathogenic factor in the development of secondary hyperparathyroidism (SHPT) in CKD. Having in regard the significance of controlling serum phosphorus levels (Pi), in this paper, the needs and obstacles to successful pharmacological management of HP in CKD are presented, with an overview of major classes of phosphate binders (PBs) and other drugs affecting Pi level, such as active vitamin D sterols and calcimimetics (CMs). In addition, their effects on progression of cardiovascular calcification and bone health are elaborated. In this regard, a PubMed search was carried out to capture all abstracts and articles relevant to the topic of CKD, HP and mineral metabolism, bone disorders and vascular/valvular calcification (VC), published from January 2007 to August 2017. The search was limited to English language, with the search terms including drug name AND hyperphosphatemia or cardiovascular calcification or bone disorder. Comparative studies, clinical studies/trials and meta-analyses related to different classes/representatives of PBs, vitamin D analogues and CMs were reviewed and research data related to their efficacy and safety compared. Keywords: chronic kidney disease, hyperphosphatemia, phosphate binders, active vitamin D sterols, calcimimetics, bone disorders, cardiovascular calcification

scholarly journals Vitamin K in Chronic Kidney Disease

Nutrients ◽  
2019 ◽  
Vol 11 (1) ◽  
pp. 168 ◽  
Author(s):  
Mario Cozzolino ◽  
Michela Mangano ◽  
Andrea Galassi ◽  
Paola Ciceri ◽  
Piergiorgio Messa ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
At Risk ◽  
Kidney Disease ◽  
Vitamin K ◽  
Bone Health ◽  
Vitamin K Deficiency ◽  
Population At Risk ◽  
K Deficiency ◽  
Subclinical Vitamin ◽  
Fat Soluble Vitamins

Vitamin K is a composite term referring to a group of fat-soluble vitamins that function as a cofactor for the enzyme γ-glutamyl carboxylase (GGCX), which activates a number of vitamin K-dependent proteins (VKDPs) involved in haemostasis and vascular and bone health. Accumulating evidence demonstrates that chronic kidney disease (CKD) patients suffer from subclinical vitamin K deficiency, suggesting that this represents a population at risk for the biological consequences of poor vitamin K status. This deficiency might be caused by exhaustion of vitamin K due to its high requirements by vitamin K-dependent proteins to inhibit calcification.

scholarly journals Chronic Kidney diseases: Role of Vitamin-K and Vitamin-D

2021 ◽  
Vol 4 (03) ◽  
Author(s):  
Vinod Kumar Varapete ◽  
Ravindra B N ◽  
Jerin S Shaji ◽  
Yaseen Mulla ◽  
Jiss P Jose ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Vitamin D ◽  
Kidney Disease ◽  
High Blood Pressure ◽  
Vitamin K ◽  
Kidney Diseases ◽  
Elevated Serum

Chronic kidney disease is the most common form of kidney disease and high blood pressure is the most common cause the pressure on the glomeruli increases due to high blood pressure which can prove to be very dangerous. Lack in VITAMIN D isn't restricted to the dynamic chemical, calcitriol (25-hydroxycholecalciferol) is likewise insufficient in many patients with constant kidney sickness (CKD), free of their fundamental renal capacity. Diminishes in calcitriol happen generally right off the bat in the movement of kidney illness and may originate before the increment in PTH. These progressions in calcitriol and PTH add to the upkeep of moderately ordinary serum and calcium fixations until the glomerular filtration rate (GFR) diminishes to <20–25%; nonetheless, the outcome is the potential advancement of bone and vascular sickness. Vitamin K intake and long-term vitamin K status are expressed by a high percentage of undercarboxylated OC (uOC). Vitamin D, which is needed for uOC development, and parathyroid hormone (PTH), which is often elevated in patients with CKD, are also affected by osteocalcin levels. Therefore, elevated serum uOC is present in patients with chronic kidney disease (CKD) with hyperparathyroidism, but this does not generally mean that they are deficient in vitamin K.

scholarly journals Blood vitamins status in patients with stages 2-5 chronic kidney disease

2018 ◽  
pp. 29-33
Author(s):  
I. Dudar ◽  
Y. Gonchar ◽  
V. Savchuk ◽  
O. Loboda
Keyword(s):  
Chronic Kidney Disease ◽  
Vitamin D ◽  
Trace Elements ◽  
Folic Acid ◽  
Kidney Disease ◽  
Vitamin K ◽  
Biologically Active ◽  
Hydroxyvitamin D ◽  
Vitamin D Levels ◽  
Significant Difference

Patients with chronic kidney disease (CKD) are prone to development hypovitaminosis due to dietary constraints, diseases of the gastrointestinal tract, comorbid conditions, etc. Determination of vitamins level in patients with CKD will allow timely correction of their deficiency, prevent the development of hypervitaminosis and reduce oxidative stress. The purpose of the study was to examine the level of vitamins depending on the stage of CKD. Methods. Vitamin D levels (level 25-hydroxyvitamin D), A, E, B12, K, folic acid were determined in 44patients with CKD stages II-V(mean age 54,63 ± 2,63 years, 24 men 55%). According to the study, patients should not have received any drugs or biologically active additives containing vitamins for 3 months. Results. There was no significant difference in the level of studied vitamins in CKD st. II-III. There was a significant decrease in the levels of vitamin K, folic acid, and vitamin D levels with the progression of CKD. Vitamin A levels in CKD st. IV, V compared to CKD st. II were significantly higher. Considering large number drugs containing vitamins and trace elements and wide uncontrolled use in the population, in particular in patients with CKD, it is important to continue to study the levels of vitamins and trace elements in patients at different stages of the CKD, depending on the CKD nosology. Study of efficiency and safety applying vitamins in patients with CKD, particularly in the late stages of CKD, are appropriate. Conclusions. For patients with CKD characteristic of vitamins deficiency (in our study vitamin K, folic acid), but also an increase in their levels (vitamins A and E). Progression of CKD is accompanied by a change in the levels of vitamins. A significant decrease in the level of vitamin K, folic acid, vitamin D was notedfor patients with GFR <30 ml/min/1.73 m2.

No effect of vitamin D supplementation on metabolic parameters but on lipids in patients with type 2 diabetes and chronic kidney disease

2020 ◽  
pp. 1-10
Author(s):  
Jiwoon Kim ◽  
Ji Sun Nam ◽  
Heejung Kim ◽  
Hye Sun Lee ◽  
Jung Eun Lee
Keyword(s):  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Vitamin D ◽  
Kidney Disease ◽  
Vitamin D Supplementation ◽  
Lipid Profiles ◽  
Metabolic Parameters ◽  
Injection Group ◽  
Different Doses

Abstract. Background/Aims: Trials on the effects of cholecalciferol supplementation in type 2 diabetes with chronic kidney disease patients were underexplored. Therefore, the aim of this study was to investigate the effects of two different doses of vitamin D supplementation on serum 25-hydroxyvitamin D [25(OH)D] concentrations and metabolic parameters in vitamin D-deficient Korean diabetes patients with chronic kidney disease. Methods: 92 patients completed this study: the placebo group (A, n = 33), the oral cholecalciferol 1,000 IU/day group (B, n = 34), or the single 200,000 IU injection group (C, n = 25, equivalent to 2,000 IU/day). 52% of the patients had less than 60 mL/min/1.73m2 of glomerular filtration rates. Laboratory test and pulse wave velocity were performed before and after supplementation. Results: After 12 weeks, serum 25(OH)D concentrations of the patients who received vitamin D supplementation were significantly increased (A, -2.4 ± 1.2 ng/mL vs. B, 10.7 ± 1.2 ng/mL vs. C, 14.6 ± 1.7 ng/mL; p < 0.001). In addition, the lipid profiles in the vitamin D injection group (C) showed a significant decrease in triglyceride and a rise in HDL cholesterol. However, the other parameters showed no differences. Conclusions: Our data indicated that two different doses and routes of vitamin D administration significantly and safely increased serum 25(OH)D concentrations in vitamin D-deficient diabetes patients with comorbid chronic kidney disease. In the group that received the higher vitamin D dose, the lipid profiles showed significant improvement, but there were no beneficial effects on other metabolic parameters.

FGF23, iron and vitamin D metabolism in chronic kidney disease

2016 ◽  
Author(s):  
Isabelle Piec ◽  
Allison Chipchase ◽  
Holly Nicholls ◽  
Jonathan Tang ◽  
Christopher Washbourne ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Vitamin D ◽  
Kidney Disease ◽  
Vitamin D Metabolism
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