1. Low vitamin K1 intake in haemodialysis patients
- Author
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Alberto Vianello, Antonio Piccoli, Agostino Naso, Irene Santinello, Luciana Bonfante, Adamasco Cupisti, Marianna Noale, Maurizio Gallieni, Nicola Veronese, Sandro Giannini, Giorgio Iervasi, Daniele Ciurlino, Andrea Aghi, Sandro Lucatello, Claudia D’Alessandro, Mario Plebani, Fabrizio Fabris, Maurizio Rossini, Stefania Sella, Giovanni Tripepi, Giovanni Tarroni, Maria Fusaro, Fusaro, M., D'Alessandro, C., Noale, M., Tripepi, G., Plebani, M., Veronese, N., Iervasi, G., Giannini, S., Rossini, M., Tarroni, G., Lucatello, S., Vianello, A., Santinello, I., Bonfante, L., Fabris, F., Sella, S., Piccoli, A., Naso, A., Ciurlino, D., Aghi, A., Gallieni, M., and Cupisti, A.
- Subjects
Male ,medicine.medical_treatment ,030232 urology & nephrology ,030204 cardiovascular system & hematology ,Recommended Dietary Allowances ,Critical Care and Intensive Care Medicine ,not known ,Body Mass Index ,chemistry.chemical_compound ,0302 clinical medicine ,Matrix gla protein ,Prevalence ,Micronutrients ,Nutrition and Dietetics ,biology ,Vitamin K 1 ,Middle Aged ,Micronutrient ,Haemodialysis ,Osteocalcin ,Dialysis ,Diet ,Menaquinone ,Nutrition ,Phylloquinone ,Female ,Dietary Proteins ,Waist Circumference ,Vitamin ,medicine.medical_specialty ,Nutritional Status ,03 medical and health sciences ,Renal Dialysis ,Internal medicine ,Vitamin K deficiency ,Dietary Carbohydrates ,medicine ,Humans ,Vitamin B12 ,Renal Insufficiency, Chronic ,Aged ,Retrospective Studies ,business.industry ,medicine.disease ,Dietary Fats ,Nutrition Assessment ,Endocrinology ,chemistry ,Case-Control Studies ,biology.protein ,Vitamin K Deficiency ,business ,Calcification - Abstract
Background & aims Vitamin K acts as a coenzyme in the γ-carboxylation of vitamin K-dependent proteins, including coagulation factors, osteocalcin, matrix Gla protein (MGP), and the growth arrest-specific 6 (GAS6) protein. Osteocalcin is a key factor for bone matrix formation. MGP is a local inhibitor of soft tissue calcification. GAS6 activity prevents the apoptosis of vascular smooth muscle cells. Few data on vitamin K intake in chronic kidney disease patients and no data in patients on a Mediterranean diet are available. In the present study, we evaluate the dietary intake of vitamin K1 in a cohort of patients undergoing haemodialysis. Methods In this multi-centre controlled observational study, data were collected from 91 patients aged >18 years on dialysis treatment for at least 12 months and from 85 age-matched control subjects with normal renal function. Participants completed a food journal of seven consecutive days for the estimation of dietary intakes of macro- and micro-nutrients (minerals and vitamins). Results Compared to controls, dialysis patients had a significant lower total energy intake, along with a lower dietary intake of proteins, fats, carbohydrates, fibres, and of all the examined minerals (Ca, P, Fe, Na, K, Zn, Cu, and Mg). With the exception of vitamin B12, vitamins intake followed a similar pattern, with a lower intake in vitamin A, B1, B2, C, D, E, folates, K1 and PP. These finding were confirmed also when normalized for total energy intake or for body weight. In respect to the adequate intakes recommended in the literature, the prevalence of a deficient vitamin K intake was very high (70–90%) and roughly double than in controls. Multivariate logistic model identified vitamin A and iron intake as predictors of vitamin K deficiency. Conclusions Haemodialysis patients had a significantly low intake in vitamin K1, which could contribute to increase the risk of bone fractures and vascular calcifications. Since the deficiency of vitamin K intake seems to be remarkable, dietary counselling to HD patients should also address the adequacy of vitamin K dietary intake and bioavailability. Whether diets with higher amounts of vitamin K1 or vitamin K supplementation can improve clinical outcomes in dialysis patients remains to be demonstrated. © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism
- Published
- 2017