Vitamin K₂ alters bone metabolism markers in hemodialysis patients with a low serum parathyroid hormone level

Nephron Clin Pract. 2011;117(1):c15-9. doi: 10.1159/000319642. Epub 2010 Aug 3.

Abstract

Background: A low level of intact parathyroid hormone (PTH) is an indicator of adynamic bone disease in hemodialysis patients, and is associated with a significant increase of all-cause mortality. Thus, effective treatment for adynamic bone disease is required. We previously investigated the effect of vitamin K₂ on adynamic bone disease. In this study, we assessed the efficacy of oral vitamin K₂ in a controlled trial.

Methods: Forty hemodialysis patients with low intact PTH levels (<100 pg/ml) were randomly divided into two groups, which were a vitamin K₂ group receiving oral menatetrenone (45 mg/day) for 1 year and a control group without vitamin K₂. Venous blood samples were collected at baseline and during the study for measurement of bone metabolism parameters.

Results: Thirty-three patients completed follow-up. There was a significant increase of the serum intact osteocalcin level after 1 month of vitamin K₂ administration. Serum levels of intact PTH, bone alkaline phosphatase, and cross-linked N-terminal telopeptide of type I collagen increased significantly after 12 months in the vitamin K₂ group. The serum osteoprotegerin level was decreased after 12 months in the vitamin K₂ group, but the change was not significant.

Conclusion: Vitamin K₂ therapy improves bone remodeling in hemodialysis patients with a low intact PTH level.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Alkaline Phosphatase / blood
  • Biomarkers / blood
  • Bone Diseases / etiology*
  • Bone Diseases / metabolism*
  • Bone Remodeling / drug effects
  • Collagen Type I / blood
  • Female
  • Humans
  • Male
  • Middle Aged
  • Osteocalcin / blood
  • Parathyroid Hormone / blood*
  • Peptides / blood
  • Renal Dialysis / adverse effects*
  • Statistics, Nonparametric
  • Vitamin K 2 / analogs & derivatives*
  • Vitamin K 2 / pharmacology
  • Vitamin K 2 / therapeutic use

Substances

  • Biomarkers
  • Collagen Type I
  • Parathyroid Hormone
  • Peptides
  • collagen type I trimeric cross-linked peptide
  • Osteocalcin
  • Vitamin K 2
  • menatetrenone
  • Alkaline Phosphatase