Vitamin K is involved in the production of Bone and Matrix Gla Proteins (BGP and MGP ), regulating bone and vascular health. We carried out an observational study to evaluate an association between bone disease therapy and levels BGP and MGP in hemodialysis patients.
In 387 hemodialysis patients we determined BGP, MGP and routine biochemistry. We evaluated vertebral fractures (VF), aortic (AoVC) and iliac (IaVC) calcifications.
VF and VC were associated with reduced BGP levels ( VF 213 vs 151, p<0.01; AoVC 270 vs 158, p<0.001, IaVC 205 vs 159, p=0.01) 19.9% patients died during follow-up. Mean follow-up was to 2.7±0.5 years. Median MGP was significantly lower (15.0 versus 19.7 nmol/L, p=0.02) in nonsurvivors.
Multivariate regression showed an increase BGP levels of 37.7% (p=0.0002) and of 20.1% (p=0.0228) in patients calcimimetics (19.4%) and Vitamin D analogs (19.9%) treated, respectively. Patients calcium acetate binding treated (5.4%) and calcimimetic treated we found an increase of 30.4% (p=0.0438 ) and of 21% (p=0.0142) respectively.
Lower BGP levels in patients with high prevalence of VF and VC. Lower MGP levels in non survivors. Calcimimetics and vitamin D analogs increase BGP levels. Calcium acetate binding and calcimimetic increase MGP levels. These drugs could have a role in the protection of bone and vascular health.
