Daily intake and serum concentration of menaquinone-4 (MK-4) in haemodialysis patients with chronic kidney disease.
OBJECTIVE
Decreased concentration of menaquinone-4 (MK-4) seems to be an important risk factor of vascular calcification in haemodialysis (HD) patients. Optimal dietary intake, as well as serum MK-4 reference range, in HD has not been determined, yet. The aim of the present study was to assess daily vitamin K1 and MK-4 intakes and their relation to serum MK-4 concentration in HD patients.


METHODS
Daily vitamin K1 and MK-4, micro- and macronutrients and energy intakes were assessed using 3-day food diary completed by patients and serum MK-4 concentration was measured by HPLC [limit of quantification (LOQ): 0.055 ng/mL] in 85 HD patients (51 males) and 22 apparently healthy subjects.


RESULTS
Daily MK-4 intake was significantly lower (by 29%) among HD, while K1 consumption was similar in both groups. Daily MK-4 intake was associated with fat and protein consumption in HD (r=0.43, p<0.001 and r=0.33, p=0.004, respectively). In HD serum MK-4 concentration was more frequently below LOQ (in 41% HD and 5% controls, p<0.001) and in those HD with quantifiable values was lower than in the controls (by 42%). The correlations between MK-4 concentrations and both MK-4 and K1 daily intakes were weaker in HD (r=0.38 and r=0.30 respectively) than in the control group (r=0.47 and r=0.45, respectively). In multiple regression analysis the variability of serum MK-4 concentrations in HD patients was explained by its daily intake.


CONCLUSIONS
Decreased serum MK-4 concentration in HD patients is caused by lower dietary MK-4 intake, mainly due to diminished meat consumption, and in addition, probably reduced K1 conversion.
Health Promotion and Obesity Management Unit, Department of Pathophysiology, Medical Faculty in Katowice, Medical University of Silesia, Medyków 18, 40-752 Katowice, Poland; Department of Nephrology, Transplantation and Internal Medicine, Medical Faculty in Katowice, Medical University of Silesia, Francuska 20-24, 40-027 Katowice, Poland.
Katarzyna
K
Wyskida
Pathophysiology Unit, Department of Pathophysiology, Medical Faculty in Katowice, Medical University of Silesia, Medyków 18, 40-752 Katowice, Poland.
Agnieszka
A
Żak-Gołąb
Department of Internal Medicine and Clinical Pharmacology, Medical Faculty in Katowice, Medical University of Silesia, Medyków 14, 40-752 Katowice, Poland.
Krzysztof
K
Łabuzek
Department of Internal Medicine and Clinical Pharmacology, Medical Faculty in Katowice, Medical University of Silesia, Medyków 14, 40-752 Katowice, Poland.
Dariusz
D
Suchy
Department of Nephrology, Transplantation and Internal Medicine, Medical Faculty in Katowice, Medical University of Silesia, Francuska 20-24, 40-027 Katowice, Poland.
Rafał
R
Ficek
Dialysis Center in Tarnowskie Góry, Fresenius Nephrocare, Pyskowicka 47, 42-612 Tarnowskie Góry, Poland.
Kornel
K
Pośpiech
Health Promotion and Obesity Management Unit, Department of Pathophysiology, Medical Faculty in Katowice, Medical University of Silesia, Medyków 18, 40-752 Katowice, Poland.
Magdalena
M
Olszanecka-Glinianowicz
Department of Internal Medicine and Clinical Pharmacology, Medical Faculty in Katowice, Medical University of Silesia, Medyków 14, 40-752 Katowice, Poland.
Bogusław
B
Okopień
Department of Nephrology, Transplantation and Internal Medicine, Medical Faculty in Katowice, Medical University of Silesia, Francuska 20-24, 40-027 Katowice, Poland.
Andrzej
A
Więcek
Pathophysiology Unit, Department of Pathophysiology, Medical Faculty in Katowice, Medical University of Silesia, Medyków 18, 40-752 Katowice, Poland. Electronic address: chj@poczta.fm.
Jerzy
J
Chudek
D016022:Case-Control Studies; D002851:Chromatography, High Pressure Liquid; D015930:Diet Records; D004041:Dietary Fats / Q000008:administration & dosage; D004044:Dietary Proteins / Q000008:administration & dosage; D002149:Energy Intake; D005260:Female; D006490:Hemostatics / Q000008:administration & dosage* / Q000097:blood; D006801:Humans; D057230:Limit of Detection; D008297:Male; D008875:Middle Aged; D064167:Recommended Dietary Allowances; D012016:Reference Values; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000503:physiopathology / Q000628:therapy; D061205:Vascular Calcification; D010837:Vitamin K 1 / Q000008:administration & dosage* / Q000097:blood; D024482:Vitamin K 2 / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000097:blood
D004041:Dietary Fats; D004044:Dietary Proteins; D006490:Hemostatics; D024482:Vitamin K 2; C030814:menatetrenone; D010837:Vitamin K 1
Chronic kidney disease; Haemodialysis; Menaquinone-4; Phylloquinone; Vitamin K intake