Vitamin K deficiency, a critical factor in chronic kidney disease

Vitamin K is a fat-soluble vitamin found in food and supplements. Vitamin K is needed for blood coagulation and calcium-binding in bones and other tissues. According to research, Patients with chronic kidney disease (CKD) have subclinical vitamin K insufficiency. CKD gradually causes the renal function to decrease over months to years. Initial CKD symptoms include leg swelling, fatigue, vomiting, loss of appetite, and confusion.

Vitamin K shortage may be induced by vitamin K-dependent proteins' increased need to suppress calcification. Low-potassium and phosphate diets for CKD patients increase this deficiency. Circulating non-phosphorylated non-carboxylated Gla protein is linked to cardiovascular illness in CKD (e.g., hyperlipidemia, hypertension). Non-carboxylated Gla protein is associated with vitamin K deficiency in older people without CKD.Haemodialysis CKD patients with low vitamin K risk arterial and venous thrombosis. Vitamin K1 deficiency may induce vertebral fracture.

Haemodialysis patients treated with warfarin (a vitamin K antagonist) for over a year had an increased incidence of vertebral fractures. Vitamin K treatment reduced bone loss in 13 randomised controlled studies. 1% of CKD patients develop calciphylaxis, a deadly condition. 50% of CKD5D patients on vitamin K antagonists experience calciphylaxis. Vitamin K, especially vitamin K2, may be an essential alternative for calcification-prone CKD patients.

The writer is an Asst Professor of Pharmacy at Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj, Bangladesh. E-mail: dmt.islam@bsmrstu.edu.bd