Altered vitamin K biodistribution and metabolism in experimental and human chronic kidney disease.
Kidney International online 11 November 2021, https://doi.org/10.1016/j.kint.2021.10.029
NadineKaeslerPhD12FelixSchreibingMD12ThimoteusSpeerMD, PhD34Sofia de laPuente-SecadesM.Sc5NikolasRappM.Sc6ChristianeDrechslerMD7NazaninKabganiPhD2ChristophKuppeMD12PeterBoorMD, PhD81VeraJankowskiPhD5LeonSchurgersPhD126RafaelKramannMD, PhD129∗JürgenFloegeMD1∗
Chronic kidney disease (CKD) is accompanied with extensive cardiovascular calcification, in part correlating with functional vitamin K deficiency. Here, we sought to determine causes for vitamin K deficiency beyond reduced dietary intake. Initially, vitamin K uptake and distribution into circulating lipoproteins after a single administration of vitamin K1 plus K2 (menaquinone 4 and menaquinone 7, respectively) was determined in patients on dialysis therapy and healthy individuals.
The patients incorporated very little menaquinone 7 but more menaquinone 4 into high density lipoprotein (HDL) and low density lipoprotein particles than did healthy individuals.
In contrast to healthy persons, HDL particles from the patients could not be spiked with menaquinone 7 in vitro and HDL uptake was diminished in osteoblasts. A reduced carboxylation activity (low vitamin K activity) of uremic HDL particles spiked with menaquinone 7 vs. that of controls was confirmed in a bioassay using human primary vascular smooth muscle cells. Kidney menaquinone 4 tissue levels were reduced in 5/6-nephrectomized versus sham-operated C57BL/6 mice after four weeks of a vitamin K rich diet. From the analyzed enzymes involved in vitamin K metabolism, kidney HMG-CoA reductase protein was reduced in both rats and patients with CKD. In a trial on the efficacy and safety of atorvastatin in 1051 patients with type 2 diabetes receiving dialysis therapy, no pronounced vitamin K deficiency was noted. However, the highest levels of PIVKA-II (biomarker of subclinical vitamin K deficiency) were noted when a statin was combined with a proton pump inhibitor.
Thus, profound disturbances in lipoprotein mediated vitamin K transport and metabolism in uremia suggest that menaquinone 7 supplementation to patients on dialysis therapy has reduced efficacy.
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see also Overview Kidney and vitamin D
Peritoneal dialysis in titles in VitaminDWiki (3 titles as of Oct 2021)
CKD or CHRONIC KIDNEY DISEASE in title of 65 pages as of Dec 2022
- Kidney Inflammation not reduced by 30 ng Vitamin D (many health problems need 50 ng) – Nov 2022
- Chronic Kidney Disease decreases Vitamin D in 4 ways – Nov 2017
- Half as much chronic kidney disease infection if supplement with Vitamin D – 2018
- 2.4 times more likely to die if have Chronic Kidney Disease and low vitamin D - Sept 2016
- 4X more Chronic Kidney disease patients are now using vitamin D – March 2014
- Poor kidneys rarely get enough or the right form of vitamin D – Feb 2019
Overview Kidney and vitamin D contains the following summary
- FACT: The Kidneys are not the primary way to activate vitamin D; the tissues are
- FACT: When the Kidney has problems, there is less active vitamin D (Calcitriol) for the body
- FACT: When the Kidney has problems, there is increased death due to many factors - many of which are associated with lack of Calcitriol
- FACT: There are many ongoing intervention clinical trials trying to determine how much of what kind of vitamin D is needed to treat the problem
- FACT: One Randomized Controlled Trial has proven that Vitamin D treats CKD
- FACT: 38% of seniors have Chronic Kidney Disease and most are unaware of it CDC statistics 2020
- FACT: Taking extra Vitamin D, in various forms, does not cause health problems - even if poor kidney
- Suggestion: Increase vitamin D getting into body now - and increase co-factors so that the vitamin D can be better used
Sun, UV lamp, Vitamin D supplement - probably > 5,000 IU,
Nanoemulstion vitamin D (inside cheek, topically) gets activated Vitamin D to the cells without the need for healthy kidney, liver, or intestine
Calcitriol - which bypasses the need for the kidney to activate vitamin D
Problems with Calcitriol however: typically only lasts for a few hours, also, possible complications
Update: Pre-cursor of active vitamin D made from plants is better than calcitriol – Sept 2012
- Category Kidney and Vitamin D contains
Pages in BOTH the categories Vitamin K and KidneyVitamin K2 MK- 7 not as available if have Chronic Kidney Disease - Nov 2021
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