Vitamin K is a key cofactor for the activation of proteins involved in blood coagulation, apoptosis, bone mineralization regulation, and vessel health. Scientific evidence shows an important role of activated osteocalcin and matrix-Gla protein in bone and vessels, markedly affected along the course of chronic kidney disease (CKD). In fact, CKD corresponds to an unique condition of vitamin K deficiency caused by dietary restriction, intestinal dysfunction, and impaired vitamin K recycling. Clinical data suggest that vitamin K status can be modulated and this prompts us to speculate whether patients with CKD might benefit from vitamin K supplementation. However, as important as whether the improvement in vitamin K status would be able to result in better bone quality, less vascular calcification, and lower mortality rates, several issues need to be clarified. These include better standardized methods for measuring vitamin K levels, and definition of the optimal concentration range for supplementation in different subgroups. Here, we review the literature data concerning the impact of vitamin K deficiency and supplementation on CKD-associated mineral and bone disorders (CKD-MBD). We present and discuss the available evidence from basic science and clinical studies, and highlight perspectives for further research.

中文翻译：

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维生素K在慢性肾脏疾病的矿物质和骨骼疾病中起作用。

维生素K是激活蛋白质的关键辅因子，涉及血液凝固，凋亡，骨骼矿化调节和血管健康。科学证据表明，活化骨钙蛋白和基质Gla蛋白在骨骼和血管中起着重要作用，在慢性肾脏病（CKD）的过程中受到明显影响。实际上，CKD对应于由饮食限制，肠道功能障碍和维生素K循环障碍引起的维生素K缺乏症的独特状况。临床数据表明可以调节维生素K的状态，这促使我们推测CKD患者是否可以从补充维生素K中受益。但是，与改善维生素K状况是否能够改善骨骼质量，减少血管钙化和降低死亡率一样重要，有几个问题需要澄清。这些措施包括测量维生素K水平的更好的标准化方法，以及确定在不同亚组中补充的最佳浓度范围。在这里，我们回顾了有关维生素K缺乏和补充对与CKD相关的矿物质和骨骼疾病（CKD-MBD）的影响的文献数据。我们提出并讨论了基础科学和临床研究中的可用证据，并着重指出了进一步研究的观点。