Division of Nephrology and Hypertension, 1st Department of Internal Medicine, AHEPA Hospital, School of Medicine, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece.
Department of Nephrology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece.
Nutrients. 2022 Feb 22;14(5):925. doi: 10.3390/nu14050925.
Chronic Kidney Disease (CKD) patients are at high risk of presenting with arterial calcification or stiffness, which confers increased cardiovascular mortality and morbidity. In recent years, it has become evident that VC is an active process regulated by various molecules that may act as inhibitors of vessel mineralization. Matrix Gla Protein (MGP), one the most powerful naturally occurring inhibitors of arterial calcification, requires vitamin K as a co-factor in order to undergo post-translational γ-carboxylation and phosphrorylation and become biologically active. The inactive form of MGP (dephosphorylated, uncarboxylated dp-ucMGP) reflects vitamin K deficiency and has been repeatedly associated with surrogate markers of VC, stiffness, and cardiovascular outcomes in CKD populations. As CKD is a state of progressive vitamin K depletion and VC, research has focused on clinical trials aiming to investigate the possible beneficial effects of vitamin K in CKD and dialysis patients. In this study, we aim to review the current evidence regarding vitamin K supplementation in uremic patients.
慢性肾脏病（CKD）患者发生动脉钙化或僵硬的风险很高，这会增加心血管死亡率和发病率。近年来，人们已经清楚地认识到 VC 是一个受多种分子调节的活跃过程，这些分子可能作为血管矿化的抑制剂发挥作用。基质 Gla 蛋白（MGP）是一种最强的天然动脉钙化抑制剂，需要维生素 K 作为辅助因子，才能进行翻译后γ-羧化和磷酸化，从而具有生物活性。MGP 的无活性形式（去磷酸化、非羧化 dp-ucMGP）反映了维生素 K 的缺乏，并与 CKD 人群中 VC、僵硬和心血管结局的替代标志物反复相关。由于 CKD 是维生素 K 逐渐耗竭和 VC 的状态，因此研究的重点是针对 CKD 和透析患者的临床试验，以研究维生素 K 可能带来的有益效果。在这项研究中，我们旨在综述目前关于尿毒症患者补充维生素 K 的证据。
