Supplementary nutrients for prevention of vascular calcification in patients with chronic kidney disease

Vascular calcification (VC) and malnutrition associated with cardiovascular dis ease are common in patients with chronic kidney disease (CKD) treated with di alysis. VC, which reflects vascular aging, and malnutrition are also encountered in the non-CKD elderly population. This similarity of clinical findings suggests that the progression of CKD is related to aging and the existence of a causal re lationship between VC and malnutrition. To retard renal progression, a low or very low protein diet is usually recommended for CKD patients. Dietary edu cation may induce malnutrition and deficiency of important nutrients, such as vitamins K and D. Menaquinone-7, a type of vitamin K2, is under investigation for inhibiting VC in elderly patients without CKD, as well as for prevention of VC in patients with CKD. Nutritional vitamin D, such as cholecalciferol, may be con sidered to decrease the required dose of active vitamin D, which increases the risk of VC due to increased calcium and phosphate loads. Omega-3 fatty acids are im portant nutrients and their ability to inhibit VC needs to be evaluated in clinical trials. This review focuses on the ability of supplementary nutrients to prevent VC in patients with CKD, in whom dietary restriction is essential.