Vitamin K in hemodialysis patients

Abstract

Hemodialysis patients with kidney disease usually have vitamin K deficits in their blood, probably due to their diets. In fact, due to their pathology, these patients must reduce their intake of products rich in sodium and potassium, such as cheeses and green vegetables, which are rich in vitamin K. As this vitamin acts as a cofactor for vitamin K-dependent carboxylase, proteins that depend on this enzyme, such as matrix Gla protein (MGP), osteocalcin (OC), growth arrest specific protein 6 (Gas6) and Gla-rich protein (GRP), will be decarboxylated and inactivated. This will result in a set of changes, such as phenotypic changes in the cells of the vascular endothelium that turn into osteochondrogenic cells, a process called vascular calcification. Vascular calcification will then be responsible for increasing the stiffness of blood vessels, muscle and heart valves, and will also contribute to the acceleration of the atherosclerotic process. So, this is considered a risk factor especially for cardiovascular mortality and morbidity. The high number of patients affected by this complication results in a need to search for a therapy capable of treating vitamin K deficiency and consequently delaying the evolution of the calcification process. The possibility of supplementing these patients with vitamin K may be important and protective for the development of vascular calcification. Thus, in this article review weintend to analyze several studies that have been carried out with this objective and to understand if the use of this therapy can be useful in the management and treatment of hemodialysis patients.