Vitamin K plays a key role in the synthesis of several blood coagulation factors, but it is also involved in bone metabolism and vascular calcification. There are two forms of vitamin K: K1 and K2, which may behave differently. Oral anticoagulation with warfarin inhibits the vitamin K system. Although warfarin reduces ischemic stroke, there are concerns on hemorrhagic complications and, due to the impaired activity of other vitamin K-dependent proteins such as osteocalcin (or BGP, bone Gla protein) and MGP (matrix Gla protein), on an increased burden of bone fractures and vascular calcifications. These in turn may be significant determinants of morbidity and mortality. The geriatric population, who is often affected by bone disorders frequently related to aging itself, could benefit from a supplementation of vitamin K, but further studies are necessary to prove actual benefits, both in CKD patients and in the general population. In patients at risk of vascular calcifications and fractures, in particular elderly patients affected by CKD, the possible beneficial role of vitamin K supplementation, as well as more a selected administration of vitamin K inhibitors for anticoagulation should be considered.

Vitamin K and bone metabolism in the elderly with normal and reduced kidney function / M. Gallieni, M.A. Rizzo, S. Maggi, A. Regalia, I. Molfino, G. Crepaldi, M. Fusaro. - In: EUROPEAN GERIATRIC MEDICINE. - ISSN 1878-7649. - 4:1(2013), pp. 32-38. [10.1016/j.eurger.2012.10.001]

Vitamin K and bone metabolism in the elderly with normal and reduced kidney function

M. Gallieni
;
M.A. Rizzo;A. Regalia;M. Fusaro
2013

Abstract

Vitamin K plays a key role in the synthesis of several blood coagulation factors, but it is also involved in bone metabolism and vascular calcification. There are two forms of vitamin K: K1 and K2, which may behave differently. Oral anticoagulation with warfarin inhibits the vitamin K system. Although warfarin reduces ischemic stroke, there are concerns on hemorrhagic complications and, due to the impaired activity of other vitamin K-dependent proteins such as osteocalcin (or BGP, bone Gla protein) and MGP (matrix Gla protein), on an increased burden of bone fractures and vascular calcifications. These in turn may be significant determinants of morbidity and mortality. The geriatric population, who is often affected by bone disorders frequently related to aging itself, could benefit from a supplementation of vitamin K, but further studies are necessary to prove actual benefits, both in CKD patients and in the general population. In patients at risk of vascular calcifications and fractures, in particular elderly patients affected by CKD, the possible beneficial role of vitamin K supplementation, as well as more a selected administration of vitamin K inhibitors for anticoagulation should be considered.
Chronic kidney disease; Menaquinone; Matrix Gla protein; Bone Gla protein; Fractures
Settore MED/14 - Nefrologia
Settore MED/09 - Medicina Interna
9-nov-2012
Article (author)
File in questo prodotto:
File Dimensione Formato  
Gallieni - Eur Geritatric Med 2013 preprint.pdf

accesso aperto

Tipologia: Post-print, accepted manuscript ecc. (versione accettata dall'editore)
Dimensione 9.68 MB
Formato Adobe PDF
9.68 MB Adobe PDF Visualizza/Apri
1-s2.0-S1878764912006596-main.pdf

accesso riservato

Tipologia: Publisher's version/PDF
Dimensione 439.91 kB
Formato Adobe PDF
439.91 kB Adobe PDF   Visualizza/Apri   Richiedi una copia
Pubblicazioni consigliate

Caricamento pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/703289
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 0
  • ???jsp.display-item.citation.isi??? 0
social impact