Causes of vitamin K deficiency in patients on haemodialysis
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Causes of vitamin K deficiency in patients on haemodialysis. / Wikstrøm, Signe; Aagaard Lentz, Katrine; Hansen, Ditte; Melholt Rasmussen, Lars; Jakobsen, Jette; Post Hansen, Henrik; Andersen, Jens Rikardt.
In: Nutrients, Vol. 12, No. 9, 2513, 2020.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Causes of vitamin K deficiency in patients on haemodialysis
AU - Wikstrøm, Signe
AU - Aagaard Lentz, Katrine
AU - Hansen, Ditte
AU - Melholt Rasmussen, Lars
AU - Jakobsen, Jette
AU - Post Hansen, Henrik
AU - Andersen, Jens Rikardt
N1 - CURIS 2020 NEXS 283
PY - 2020
Y1 - 2020
N2 - Background: A low vitamin K status is common in patients on haemodialysis, and this is considered one of the reasons for the accelerated atherosclerosis in these patients. The vitamin is essential in activation of the protein Matrix Gla Protein (MGP), and the inactive form, dp-ucMGP, is used to measure vitamin K status. The purpose of this study was to investigate possible underlying causes of low vitamin K status, which could potentially be low intake, washout during dialysis or inhibited absorption capacity. Moreover, the aim was to investigate whether the biomarker dp-ucMGP is affected in these patients. Method: Vitamin K intake was assessed by a Food Frequency Questionnaire (FFQ) and absorption capacity by means of D-xylose testing. dp-ucMGP was measured in plasma before and after dialysis, and phylloquinine (vitamin K1) and dp-ucMGP were measured in the dialysate. Changes in dp-ucMGP were measured after 14 days of protein supplementation. Results: All patients had plasma dp-ucMGP above 750 pmol/L, and a low intake of vitamin K. The absorption capacity was normal. The difference in dp-ucMGP before and after dialysis was -1022 pmol/L (p < 0.001). Vitamin K1 was not present in the dialysate but dp-ucMGP was at a high concentration. The change in dp-ucMGP before and after protein supplementation was -165 pmol/L (p = 0.06). Conclusion: All patients had vitamin K deficiency. The reason for the low vitamin K status is not due to removal of vitamin K during dialysis or decreased absorption but is plausibly due to a low intake of vitamin K in food. dp-ucMGP is washed out during dialysis, but not affected by protein intake to a clinically relevant degree.
AB - Background: A low vitamin K status is common in patients on haemodialysis, and this is considered one of the reasons for the accelerated atherosclerosis in these patients. The vitamin is essential in activation of the protein Matrix Gla Protein (MGP), and the inactive form, dp-ucMGP, is used to measure vitamin K status. The purpose of this study was to investigate possible underlying causes of low vitamin K status, which could potentially be low intake, washout during dialysis or inhibited absorption capacity. Moreover, the aim was to investigate whether the biomarker dp-ucMGP is affected in these patients. Method: Vitamin K intake was assessed by a Food Frequency Questionnaire (FFQ) and absorption capacity by means of D-xylose testing. dp-ucMGP was measured in plasma before and after dialysis, and phylloquinine (vitamin K1) and dp-ucMGP were measured in the dialysate. Changes in dp-ucMGP were measured after 14 days of protein supplementation. Results: All patients had plasma dp-ucMGP above 750 pmol/L, and a low intake of vitamin K. The absorption capacity was normal. The difference in dp-ucMGP before and after dialysis was -1022 pmol/L (p < 0.001). Vitamin K1 was not present in the dialysate but dp-ucMGP was at a high concentration. The change in dp-ucMGP before and after protein supplementation was -165 pmol/L (p = 0.06). Conclusion: All patients had vitamin K deficiency. The reason for the low vitamin K status is not due to removal of vitamin K during dialysis or decreased absorption but is plausibly due to a low intake of vitamin K in food. dp-ucMGP is washed out during dialysis, but not affected by protein intake to a clinically relevant degree.
KW - Faculty of Science
KW - Haemodialysis
KW - Vitamin K
KW - Phylloquinone
KW - Menaquinone
KW - dp-ucMGP
KW - D-xylose test
U2 - 10.3390/nu12092513
DO - 10.3390/nu12092513
M3 - Journal article
C2 - 32825243
VL - 12
JO - Nutrients
JF - Nutrients
SN - 2072-6643
IS - 9
M1 - 2513
ER -
ID: 247876075