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Year : 2017  |  Volume : 29  |  Issue : 1  |  Page : 5-10

Effect of vitamin K1 supplementation on matrix Gla protein level and vascular calcification in hemodialysis patients

1 Professor in Internal Medicine & Nephrology Department, Faculty of Medicine Al-Azhar University, Cairo, Egypt
2 Lecturer in Internal Medicine & Nephrology Department, Faculty of Medicine-Al-Azhar University, Cairo, Egypt
3 Assistant Professor in Clinical Pathology Department, Faculty of Medicine-Al-Azhar University, Cairo, Egypt
4 Assistant Professor Radio-diagnosis, Faculty of Medicine-Al-Azhar University, Cairo, Egypt
5 Assistant Lecturer in Internal Medicine & Nephrology Department, Faculty of Medicine-Al-Azhar University, Cairo, Egypt

Correspondence Address:
Eglal Mohammed Kenawy
3 Shady Abd Al Salam street, Maimi, Alexandria
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1110-7782.207779

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Background Matrix Gla protein (MGP) is a potent calcification inhibitor of the arterial wall. Its activity depends on vitamin K-dependent γ-carboxyglutamate. Aim We aimed to investigate the effect of vitamin K1 on MGP levels after 3 months’ supplementation and the relationship between MGP level and vascular calcification. Patients and methods A prospective case–control pilot study was conducted over a period of 3 months. The study included 57 long-term hemodialysis patients in stable conditions who were divided into two groups and were compared with 27 healthy age-matched controls. Group I consisted of 28 hemodialysis patients who received vitamin K1 at 10 mg three times per week for a successive period of 3 months. Group II consisted of 29 hemodialysis patients who did not receive vitamin K. Group III consisted of 27 healthy participants as controls. The serum level of MGP was measured by radioimmunoassay; in addition, hemoglobin%, parathyroid hormone, calcium, phosphorus, sodium, potassium, alkaline phosphatase, total cholesterol, triglyceride, and carotid intima–media thickness were also measured. Plain radiograph of the abdomen in lateral view was acquired to determine the abdominal aortic calcification score at the start of the study, which was reassessed after 3 months in groups I and II. Results We found a significant increase in blood pressure, body mass index (BMI) with elevation in the serum level of MGP in patient groups than control from the start. A significant elevation in MGP level was observed in group I accompanied by a decrease in serum cholesterol level, compared with group II. We did not find any significant change in carotid intima–media thickness or abdominal aortic calcification score in either group after 3 months. There was no significant correlation between elevated MGP level and vascular calcification either. No significant difference was found in other parameters. Conclusion Vitamin K supplementation may be essential for End Stage Kidney Disease (ESKD) patients on hemodialysis. Vitamin K can increase the level of MGP and decrease cholesterol level, but its beneficial effect on the vascular bed needs a long-term study.

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