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Vitamin K in CKD Bone Disorders

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Abstract

Vitamin K is principally known because it is involved in blood coagulation. Furthermore, epidemiological studies showed that its deficit was associated with increased fragility fractures, vascular calcification and mortality. There are two main types of vitamin K vitamers: Phylloquinone (or PK) and Menaquinones (MKn). Vitamin K acts both as coenzyme of y-glutamyl carboxylase (GGCX) transforming undercarboxylated in carboxylated vitamin K-dependent proteins (e.g., Osteocalcin and Matrix Gla Protein) and as a ligand of the nuclear steroid and xenobiotic receptor (SXR) (in murine species Pregnane X Receptor: PXR), expressed in osteoblasts. It has been highlighted that the uremic state is a condition of greater vitamin K deficiency than the general population with resulting higher prevalence of bone fractures, vascular calcifications and mortality. The purpose of this literature review is to evaluate the protective role of Vitamin K in bone health in CKD patients.

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Authors and Affiliations

  1. National Research Council (CNR), Institute of Clinical Physiology (IFC), Pisa Via G. Moruzzi 1, 56124, Pisa, PI, Italy

    M. Fusaro

  2. Department of Medicine, University of Padova, Via Giustiniani 2, 35128, Padova, PD, Italy

    M. Fusaro

  3. Department of Experimental Diagnostic and Specialty Medicine (DIMES), Nephrology, Dialysis and Renal Transplant Unit, S. Orsola Hospital, University of Bologna, Bologna, Italy

    G. Cianciolo

  4. Laboratory of Nephrology, Department of Immunology and Microbiology, KU Leuven, Leuven, Belgium

    P. Evenepoel

  5. Department of Biochemistry, Cardiovascular Research Institute Maastricht, 6200MD, Maastricht, The Netherlands

    L. Schurgers

  6. Laboratory Medicine Unit, Department of Medicine, University of Padua, Padua, Italy

    M. Plebani

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Fusaro, M., Cianciolo, G., Evenepoel, P. et al. Vitamin K in CKD Bone Disorders. Calcif Tissue Int 108, 476–485 (2021). https://doi.org/10.1007/s00223-020-00792-2

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