However, we expect that the results of several intensive ongoing trials will shed light on this area of research. Moreover, in this study, in vitro, HDL particles isolated from HD patients presented very low (almost absent) MK-7 incorporation and when HDL particles from the study cohort were spiked with MK-7, only those isolated from healthy controls (but not those from HD patients) presented significantly decreased ucMGP levels in VSMCs. Yuen D., Pierratos A., Richardson R.M., Chan C.T. Theres still much to be understood about the differences between vitamin K1 and vitamin K2, and research is ongoing. Vitamin K, particularly as vitamin K 2, is nearly nonexistent in junk food, with little being consumed even in a healthy Western diet. and A.K. Therefore, the increased CV death rates of ESKD patients may partially reflect the accelerated rate of arterial calcification observed in these patients. Eren P.A., Turan K., Berber I., Canbakan M., Kara M., Tellioglu G., Bugan U., Sevinc C., Turkmen F., Titiz M.I. Detection of coronary and peripheral artery calcification in patients with chronic kidney disease stages 3 and 4, with and without diabetes. Zebboudj A.F., Imura M., Bostrom K. Matrix GLA protein, a regulatory protein for bone morphogenetic protein-2. That class is made up of vitamin K1, as well as vitamin K2 and vitamin K2s 10 subtypes, known as MK-4 to MK-13. In fact, some think that vitamin K2 may be the missing link between diet and several chronic diseases. Vitamin D supports bone health, builds immunity, as well as helps in improving energy and mood. Chatrou M.L., Cleutjens J.P., van der Vusse G.J., Roijers R.B., Mutsaers P.H., Schurgers L.J. Vitamin K2 is gaining recognition for its effects on blood clotting, heart health and bone health. Off. Before The same is true of vitamin K. K vitamins are fat-soluble, meaning they dissolve in fats and oils. The mean age of enrolled patients was lower than that of typical CKD 3b-4 patients, and it could be hypothesized that the study population did not exhibit severe vitamin K depletion. Its true - thats why were here to tell you everything you need to know about the role that vitamin K2 and calcium play in our health, from what these nutrients are to exactly how much we should be consuming of each to experience their health benefits. Long-term studies in Japanese women have observed similar benefits, though very high doses were used in these cases. Oikonomaki T., Papasotiriou M., Ntrinias T., Kalogeropoulou C., Zabakis P., Kalavrizioti D., Papadakis I., Goumenos D.S., Papachristou E. The effect of vitamin K2 supplementation on vascular calcification in haemodialysis patients: A 1-year follow-up randomized trial. Mathew S., Tustison K.S., Sugatani T., Chaudhary L.R., Rifas L., Hruska K.A. Vitamin K2: Everything You Need to Know - Healthline Combine Vitamin D With Vitamin K2 For Maximum Benefits: Nutritionist There is evidence for some positive effect, and there are ongoing studies, says Dr. Deal. Finally, MGP has the ability to remove calcium and extracellular matrix from the vessel walls [48]. Vitamins and Minerals for Goats | CALS Broccoli: Health benefits, nutrition, and tips - Medical News Today All authors have read and agreed to the published version of the manuscript. Schurgers et al. Therefore, in RCTs investigating the effect of vitamin K on CKD patients vitamin D status should be always assessed and corrected at baseline [97]. As mentioned above, vitamin K2 plays a central role in the metabolism of calcium, the main mineral found in your bones and teeth. So if youre curious about the relationship between vitamin K2 and calcium, keep reading. However, more studies on the roles of vitamin K subtypes are needed. J. Kidney Dis. Out of 13 studies, only one failed to show significant improvement. Some early studies are showing that vitamin K2 supplements may reduce fractures and improve bone quality in people with osteoporosis. Finally, roughly nine of ten patients in the K group were treated with phosphate binders such as sevelamer, which have been reported to limit the biologic availability of vitamin K [64]. Moreover, in the Valkyrie trial [90] the incidence of stroke did not differ between the groups receiving rivaroxaban and rivaroxaban plus MK-7, and hemorrhagic stroke occurred only in the warfarin group. . It was also discovered by the dentist Weston Price, who traveled the world in the early 20th century, studying the relationship between diet and disease in different populations. Healthline Media does not provide medical advice, diagnosis, or treatment. There are some foods that are both naturally healthy and rich in vitamin K2.. The Effect on Vascular Calcification of Replacing Warfarin by Rivaroxaban With or Without Vitamin K2 in Hemodialysis Patients (Valkyrie) RCT [88] enrolled 132 HD patients with atrial fibrillation and randomized them to a vitamin K antagonist (warfarin), rivaroxaban, or rivaroxaban combined with 2000 g of MK-7 thrice weekly. Even Bone morphogenetic protein 7: A novel treatment for chronic renal and bone disease. Moreover, the study had a high drop-out rate of 51%, and only 52 patients were ultimately included in the analysis. The initial discovery was reported in a German scientific journal, where it was called Koagulationsvitamin. Thats where the K in vitamin K comes from (1). The function and clinical importance of this inhibitor of VC was first recognized by Luo et al., who found that MGP-deficient animals (knockout models, MGP--/--), develop to term but die within eight weeks due to accelerated VC leading to blood vessel rupture in the aorta [41]. However, thus far the results of such supplementation on the progression of VC remain ambiguous and contraindicatory. Vitamin K has been shown to help activate a protein that helps prevent calcium from depositing in your arteries, Zumpano explains. Compared to the general population, the prevalence of arterial microcalcification is 45 times greater in CKD patients [10]. 25 Mar 2022 Recent studies clearly demonstrate that vitamin D3 and vitamin K2 are essential to good health. Riphagen I.J., Keyzer C.A., Drummen N.E.A., de Borst M.H., Beulens J.W.J., Gansevoort R.T., Geleijnse J.M., Muskiet F.A.J., Navis G., Visser S.T., et al. Menaquinones can also be produced by bacteria in the human body. INTRODUCTION. However, some researchers are not convinced. National Institutes of Health. showed that in a cohort of 37 HD patients dp-ucMGP was an independent predictor of arterial stiffness and endothelial dysfunction as assessed by PWV and flow mediated dilation, respectively, even after adjustment for duration of dialysis, gender, age, diabetes, blood pressure, and history of CV disease [71]. Dowagers Hump: What It Is and How To Get Rid of It. Dorai H., Vukicevic S., Sampath T.K. Sweatt A., Sane D.C., Hutson S.M., Wallin R. Matrix Gla protein (MGP) and bone morphogenetic protein-2 in aortic calcified lesions of aging rats. Finally, at baseline the vitamin K group had increased proteinuria compared to the placebo group (12 versus < 3 mg/mmol) and higher prevalence of both diabetes (28.9% versus 15.6%) and CV disease (peripheral arterial disease was present at 6.7% versus 0%, heart failure was present at 6.7% versus 0%, ischemic heart disease at 37.8% versus 26.7%, and ischemic attack or stroke was 4.4% versus 2.2%), whereas all participants at baseline presented extended VC. Morena M., Jaussent I., Halkovich A., Dupuy A.M., Bargnoux A.S., Chenine L., Leray-Moragues H., Klouche K., Vernhet H., Canaud B., et al. We do not endorse non-Cleveland Clinic products or services. However, deficiencies of both K1 and K2 appear to have a negative effect. But do you know your bones also need vitamin K? New research is revealing this game-changing pair of vitamins and their effect on our hearts, our bones, and our blood sugar. Think of vitamin K as a collection of vitamins that play a similar role in your health. The presence and degree of vascular calcification (VC) are independent and each is a strong predictor of CV morbidity and mortality. https://creativecommons.org/licenses/by/4.0/, No effect on VC, vascular stiffness or cardiac valve calcification. In this study, we aim to review the current evidence regarding vitamin K supplementation in uremic patients. Proper Calcium Use: Vitamin K2 as a Promoter of Bone and Cardiovascular Health. Bone biomarkers help grading severity of coronary calcifications in non dialysis chronic kidney disease patients. The U.S. Food and Drug Administration has not authorized a health claim. An official website of the United States government. It should be noted that the mean age of the patients included in the K2 group was 79.6 years, and therefore the excessive calcification of arteries at this age may not be amenable to any reversal strategy. I think weve always known that theres a vitamin K2, I just dont think weve really ever given it enough credit for how much work it does in the body, says registered dietitian Julia Zumpano, RD, LD. Bellinge J.W., Dalgaard F., Murray K., Connolly E., Blekkenhorst L.C., Bondonno C.P., Lewis J.R., Sim M., Croft K.D., Gislason G. Vitamin K Intake and atherosclerotic cardiovascular disease in the danish diet cancer and health study. Porter C.J., Stavroulopoulos A., Roe S.D., Pointon K., Cassidy M.J. Cancer is a common cause of death in Western countries. Van Ballegooijen A.J., Cepelis A., Visser M., Brouwer I.A., Van Schoor N.M., Beulens J.W. Gut bacteria in your large intestine also produced vitamin K2. Morena M., Jaussent I., Dupuy A.M., Bargnoux A.S., Kuster N., Chenine L., Leray-Moragues H., Klouche K., Vernhet H., Canaud B., et al. Health risk of osteoporosis is increasing in Korean women and there were many trials to reduce and prevent osteoporotic fracture risk (1, 2).Vitamin K plays a role in bone metabolism and may decrease the risk of fracture (3, 4).Vitamin K also acts synergistically with Vitamin D on bone mineral density (BMD) and positively influences the balance of calcium, a key mineral in bone . In addition, some calcium supplements are combined with vitamins and other minerals. Then in June, the U.S. Preventive Services Task Force recommended against low-dose calcium and vitamin D supplements, citing little evidence that they actually prevent fractures and noting that they can increase the risk of . This article contains scientific references. The body also needs vitamin C to produce collagen. Vitamin K comes in two forms K1 and K2. Schlieper G., Schurgers L., Brandenburg V., Reutelingsperger C., Floege J. Vascular calcification in chronic kidney disease: An update. Fusaro et al. Massy Z.A., Henaut L., Larsson T.E., Vervloet M.G. Moe S.M., ONeill K.D., Reslerova M., Fineberg N., Persohn S., Meyer C.A. Vitamin D promotes the production of MGP and other VKDPs, whereas vitamin K and D work together to maintain calcium homeostasis in bones and circulation [93,95]. Instead, well likely need to take vitamin K2 supplements to ensure bone and cardiovascular health. Why take vitamin K2 and calcium together? 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 -carboxylation and phosphrorylation and become biologically active. A study of participants (both men and women) in the large Framingham Heart Study also showed a link between low vitamin K intake and increased risk of hip fractures. The European Food Safety Authority has approved a health claim for vitamin K, noting that a cause-and-effect relationship has been established between the dietary intake of vitamin K and the maintenance of normal bone.. In a study by Schlieper et al., the authors reported that in 17 HD patients, daily supplementation with 135 g of MK-7 for 1.5 months caused a modest 27% reduction in dp-ucMGP levels [72]. Policy. 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. If You Take Vitamin D, You May Need This Other Vitamin to Reduce - MSN Subclinical vitamin K depletion is highly prevalent in ESKD patients and has been associated with VC, vascular stiffness, mortality, and CV disease. showing the link between vitamin K2 and calcium, consumption of these nutrients together can: Reduce risk for blood-vessel calcification, Recommended daily amount of vitamin K2 and calcium, While vitamin K2 does not have its own recommended dietary intake (RDI), we can use the RDI for vitamin K1 to give us an idea of how much, Thats why FuelOrganics offers a high-quality. In one study spanning 710 years, people with the highest intake of vitamin K2 were 52% less likely to develop artery calcification and had a 57% lower risk of dying from heart disease (7). On the other hand, dp-ucMGP cannot bind to calcium/phosphate particles, hydroxyapatite, or BMP-2 and therefore loses the ability to act as an inhibitor of VC [51,52,53,54]. But lets focus here on bone health. Schurgers L.J., Barreto D.V., Barreto F.C., Liabeuf S., Renard C., Magdeleyns E.J., Vermeer C., Choukroun G., Massy Z.A. Because vitamin K is an essential co-factor for both activation steps of MGP, in vitamin K deficiency MGP is deactivated and the circulating levels of dp-ucMGP are further increased. In advanced CKD, the consequences of kidney dysfunction (particularly mineral dysregulation, inflammation and accumulation of uremic toxins) favor the osteogenic transition of vascular smooth muscle cells, through the activity of cytokines and enzymes such as Fibroblast Growth Factor-23 [15,16], osteocalcin [17,18,19], sclerostin [20,21,22], bone-morphogenetic proteins [16,23,24,25], osteoprotegerin [22,26,27,28], RUNX2 [16] and calcium-sensing receptor [29,30] that trigger the osteoblastic differentiation of VSMCs, thus promoting the onset and development of VC [31,32,33,34]. Our team of licensed nutritionists and dietitians strive to be objective, unbiased, honest and to present both sides of the argument. All newborns receive vitamin K injections to prevent the possibility of bleeding, particularly in the brain. Kurnatowska et al. At this point, researchers have yet to determine if vitamin K1 or vitamin K2 are equally responsible for clotting or if one is any more effective than the other when it comes to blood clotting. A study that analyzed data from the large Nurses Health Study found that women who consumed less than 109 micrograms (mcg) of vitamin K per day were more likely to break a hip. Vitamin K2 and calcium are two examples of essential nutrients that we can take in conjunction to not only improve the health of our bones and hearts, but to prevent future health complications from arising. https://ods.od.nih.gov/factsheets/VitaminK-Consumer/. Bone morphogenetic protein-7 (osteogenic protein-1) inhibits smooth muscle cell proliferation and stimulates the expression of markers that are characteristic of SMC phenotype in vitro. However, this powerful nutrient plays an essential role in many aspects of your health. Rennenberg R., Kessels A., Schurgers L., Van Engelshoven J., De Leeuw P., Kroon A. Vascular calcifications as a marker of increased cardiovascular risk: A meta-analysis. This vitamin works by activating a protein that assists calcium in serving its functions within the body. Brandenburg V.M., DHaese P., Deck A., Mekahli D., Meijers B., Neven E., Evenepoel P. From skeletal to cardiovascular disease in 12 steps-the evolution of sclerostin as a major player in CKD-MBD. Levy-Schousboe K., Frimodt-Mller M., Hansen D., Peters C.D., Kjrgaard K.D., Jensen J.D., Strandhave C., Elming H., Larsen C.T., Sandstrm H. Vitamin K supplementation and arterial calcification in dialysis: Results of the double-blind, randomised, placebo-controlled RenaKvit trial. First we were advised to take calcium and vitamin D supplements to strengthen our bones and protect against fractures. Witham M.D., Lees J.S., White M., Band M., Bell S., Chantler D.J., Ford I., Fulton R.L., Kennedy G., Littleford R.C. Your bones need vitamin K. But our rheumatologist explains why you probably get enough from your diet. Keyzer C.A., Vermeer C., Joosten M.M., Knapen M.H., Drummen N.E., Navis G., Bakker S.J., de Borst M.H. Your body can partly convert vitamin K1 to K2. A systematic review of controlled trials. Indeed all these associations have been reported in the literature (8, 17 . 2BLas Vegas NV 89102. There are four distinct histopathologic patterns of arterial calcification: calcification of the intima, calcification of the media, calcification of cardiac valves, and calciphylaxis. Sabrina-Wong-Peixin Haroon B.-C., Tai L.-H.L., Lynette Teo A.D., Leon Schurgers B.-W.T., Priyanka Khatri C.-C.O., Sanmay Low X.-E.Y., Jia-Neng Tan S.S., Horng-Ruey Chua S.-Y.T., Weng-Kin Wong T.-W.-L. Osteoprotegerin and sclerostin in chronic kidney disease prior to dialysis: Potential partners in vascular calcifications. According to one study showing the link between vitamin K2 and calcium, consumption of these nutrients together can: We must intake the daily recommended amount of vitamin K2 and calcium to allow this duo to work together to support our health. MGP was the first identified inhibitor of VC in experimental studies and has the ability to prevent as well as to reverse calcification of the vessel walls [40,41,42] through several pathways. found that every 0.1-unit decrease in cMGP levels doubled the risk of calciphylaxis [74]. less likely to die from heart disease related to hardened arteries, less likely to experience cardiovascular events, vitamin K2 supplements may be beneficial for some people, Dowagers Hump: What It Is and How To Get Rid of It. Moreover, the response rates were better in the study by Westenfeld et al., which was attributed to the fact that the patients enrolled by Caluwe et al. While vitamin K2 is more common in animal products, fermented foods and some kinds of cheese. 8600 Rockville Pike Moreover, there are numerous knowledge gaps and research questions that have remained unanswered to date regarding the supplementation of vitamin K in these populations, including the best form, dosage, duration of treatment, method of measuring vitamin K status, and expected response to treatment. NTS135: Unit 3 - Chapters 8 - 13 Flashcards | Quizlet In summation, although increased vitamin K intake is coherently associated with decreased risk of VC and CV disease in the general population, there is no clear-cut evidence favoring vitamin K supplementation for CKD and ESKD at present. Matrix Gla Protein (MGP) is a 12 kDa protein containing 84 amino-acids, four or five glutamate (Glu) and three serine residues which is secreted by VSMCs in the arterial wall and expressed in the bones, heart, kidneys, cartilage and arteries. So far, results have been mixed. Roumeliotis S., Dounousi E., Eleftheriadis T., Liakopoulos V. Association of the Inactive Circulating Matrix Gla Protein with Vitamin K Intake, Calcification, Mortality, and Cardiovascular Disease: A Review. There is accumulating evidence suggesting a close association between vitamin K deficiency and CV disease. In addition to circulating dp-ucMGP, Proteins Induced by Vitamin K Absence (PIVKA-II), a marker that collectively includes all the inactive under-carboxylated forms of VKDPs, is considered an optimal marker of subclinical vitamin K deficiency [98]. Some scientists have suggested that the roles of vitamins K1 and K2 are quite different, and many feel that they should be classified as separate nutrients altogether.