PDF(Pubmed)
Abstract：
Patients with chronic kidney disease (CKD) suffer disproportionately from a high burden of cardiovascular disease, which, despite recent scientific advances, remains partly understood. Vascular calcification (VC) is the result of an ongoing process of misplaced calcium in the inner and medial layers of the arteries, which has emerged as a critical contributor to cardiovascular events in CKD. Beyond its established role in blood clotting and bone health, vitamin K appears crucial in regulating VC via vitamin K-dependent proteins (VKDPs). Among these, the matrix Gla protein (MGP) serves as both a potent inhibitor of VC and a valuable biomarker (in its inactive form) for reflecting circulating vitamin K levels. CKD patients, especially in advanced stages, often present with vitamin K deficiency due to dietary restrictions, medications, and impaired intestinal absorption in the uremic environment. Epidemiological studies confirm a strong association between vitamin K levels, inactive MGP, and increased CVD risk across CKD stages. Based on the promising results of pre-clinical data, an increasing number of clinical trials have investigated the potential benefits of vitamin K supplementation to prevent, delay, or even reverse VC, but the results have remained inconsistent.
摘要：
慢性肾脏病（CKD）患者不成比例地遭受心血管疾病的高负担，which,尽管最近的科学进步，仍然部分理解。血管钙化（VC）是动脉内层和中层钙错位的持续过程的结果，已成为CKD心血管事件的关键因素。除了其在凝血和骨骼健康中的既定作用外，维生素K似乎在通过维生素K依赖性蛋白（VKDP）调节VC中至关重要。其中,基质Gla蛋白（MGP）既是VC的有效抑制剂，又是反映循环维生素K水平的有价值的生物标志物（呈非活性形式）。CKD患者,特别是在高级阶段，由于饮食限制，经常出现维生素K缺乏症，药物,在尿毒症环境中肠道吸收受损。流行病学研究证实了维生素K水平之间的强烈关联，非活动MGP,在CKD各阶段增加CVD风险。基于临床前数据的有希望的结果，越来越多的临床试验研究了补充维生素K的潜在益处，延迟,甚至反向VC，但是结果仍然不一致。
