title: Functional deficiency of vitamin K in hemodialysis patients in Upper Silesia in Poland.
abstract: OBJECTIVE
  Functional vitamin K deficiency (both K1 and K2) is postulated to be one of the most relevant links between chronic kidney disease and vascular calcification in hemodialysis (HD) patients. Recommended dietary restrictions in HD patients superimposed on diversity of eating habits across the countries may affect the prevalence of functional vitamin K deficiency. The aim of this study was to determine the level of functional vitamin K deficiency and its relation to vitamin K1 intake in HD patients in Upper Silesia in Poland.
  
  
  METHODS
  Protein-induced vitamin K absence or antagonist-II (PIVKA-II) and undercarboxylated matrix Gla protein (ucMGP) were assessed by ELISA in 153 stable, prevalent HD patients and 20 apparently healthy adults (to establish normal ranges for PIVKA-II and ucMGP). Daily phylloquinone intake was assessed using a food frequency questionnaire.
  
  
  RESULTS
  PIVKA-II and ucMGP levels were increased in 27.5 and 77.1 % of HD patients in comparison with the reference ranges in apparently healthy controls, respectively. In 45 % of cases, the increased PIVKA-II level was explained by insufficient phylloquinone intake for Polish population (recommended intake: >55 μg for women and >65 µg for men). Applying ROC analysis, we showed that vitamin K1 intake below 40.2 µg/day was associated with increased PIVKA-II levels. There was no correlation between vitamin K1 intake and plasma concentration of ucMGP, or between PIVKA-II and ucMGP.
  
  
  CONCLUSIONS
  (1) Functional vitamin K1 deficiency is explained by low vitamin K1 intake in less than half of HD patients. (2) Undercarboxylated matrix Gla protein level is a poor surrogate for functional vitamin K1 deficiency.
authors.affiliation: Health Promotion and Obesity Management Unit, Department of Pathophysiology, Medical Faculty in Katowice, Medical University of Silesia, Medyków 18, 40-752, Katowice, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Wyskida
authors.affiliation: Department of Pathophysiology, Medical Faculty in Katowice, Medical University of Silesia, Medyków 18 Street, 40-752, Katowice, Poland.|Department of Internal, Autoimmune and Metabolic Diseases, Medical Faculty in Katowice, Medical University of Silesia, Medyków 14, 40-752, Katowice, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Żak-Gołąb
authors.affiliation: Dialysis Center in Rybnik, Regional Specialist Hospital No. 3, Energetyków 46, 44-200, Rybnik, Poland.
authors.forename: Jarosław
authors.initials: J
authors.lastname: Wajda
authors.affiliation: Dialysis Center in Tychy, Centrum Dializa Sosnowiec, Narcyzów 24, 43-100, Tychy, Poland.|Dialysis Center in Pszczyna, Centrum Dializa Sosnowiec, Antesa 11, 43-200, Pszczyna, Poland.
authors.forename: Dariusz
authors.initials: D
authors.lastname: Klein
authors.affiliation: Dialysis Center in Siemianowice Śląskie, Nefrolux, Szpitalna 6, 41-100, Siemianowice Śląskie, Poland.
authors.forename: Joanna
authors.initials: J
authors.lastname: Witkowicz
authors.affiliation: Department of Nephrology, Transplantation and Internal Medicine, Medical Faculty in Katowice, Medical University of Silesia, Francuska 20-24, 40-027, Katowice, Poland.
authors.forename: Rafał
authors.initials: R
authors.lastname: Ficek
authors.affiliation: Dialysis Center in Katowice, Centrum Dializa Sosnowiec, Medyków 17, 40-752, Katowice, Poland.
authors.forename: Sylwia
authors.initials: S
authors.lastname: Rotkegel
authors.affiliation: Dialysis Center in Chorzów, Centrum Dializa Sosnowiec, Strzelców Bytomskich 11, 41-500, Chorzów, Poland.
authors.forename: Urszula
authors.initials: U
authors.lastname: Spiechowicz
authors.affiliation: Dialysis Center in Żory, Centrum Dializa Sosnowiec, Dąbrowskiego 20, 44-241, Żory, Poland.|Dialysis Center in Wodzisław Śląski, Centrum Dializa Sosnowiec, Leszka 10, 44-313, Wodzisław Śląski, Poland.
authors.forename: Joanna
authors.initials: J
authors.lastname: Kocemba Dyczek
authors.affiliation: Dialysis Center in Sosnowiec, Centrum Dializa Sosnowiec, Jabłoniowa 27, 41-200, Sosnowiec, Poland.
authors.forename: Jarosław
authors.initials: J
authors.lastname: Ciepał
authors.affiliation: Health Promotion and Obesity Management Unit, Department of Pathophysiology, Medical Faculty in Katowice, Medical University of Silesia, Medyków 18, 40-752, Katowice, Poland.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Olszanecka-Glinianowicz
authors.affiliation: Department of Nephrology, Transplantation and Internal Medicine, Medical Faculty in Katowice, Medical University of Silesia, Francuska 20-24, 40-027, Katowice, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Więcek
authors.affiliation: Department of Pathophysiology, Medical Faculty in Katowice, Medical University of Silesia, Medyków 18 Street, 40-752, Katowice, Poland. chj@poczta.fm.
authors.forename: Jerzy
authors.initials: J
authors.lastname: Chudek
mesh_terms: D015415:Biomarkers / Q000097:blood*; D002135:Calcium-Binding Proteins / Q000097:blood* / Q000378:metabolism; D016022:Case-Control Studies; D004032:Diet; D016326:Extracellular Matrix Proteins / Q000097:blood* / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011044:Poland; D011498:Protein Precursors / Q000097:blood*; D011516:Prothrombin; D012372:ROC Curve; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000628:therapy*; D010837:Vitamin K 1 / Q000008:administration & dosage*; D014813:Vitamin K Deficiency / Q000097:blood*; D000097568:Matrix Gla Protein
chemical_list: D015415:Biomarkers; D002135:Calcium-Binding Proteins; D016326:Extracellular Matrix Proteins; D011498:Protein Precursors; D011516:Prothrombin; D010837:Vitamin K 1; D000097568:Matrix Gla Protein; C008208:acarboxyprothrombin
keywords: Hemodialysis; Nutrition; PIVKA-II; Undercarboxylated MGP; Vitamin K intake