Supplementary nutrients for prevention of vascular calcification in patients with chronic kidney disease

다국어 초록 (Multilingual Abstract)

Vascular calcification (VC) and malnutrition associated with cardiovascular disease are common in patients with chronic kidney disease (CKD) treated with dialysis. VC, which reflects vascular aging, and malnutrition are also encountered in the non-CKD elderly population. This similarity of clinical findings suggests that the progression of CKD is related to aging and the existence of a causal relationship between VC and malnutrition. To retard renal progression, a low‑ or very‑low‑protein diet is usually recommended for CKD patients. Dietary education may induce malnutrition and deficiency of important nutrients, such as vitamins K and D. Menaquinone-7, a type of vitamin K2, is under investigation for inhibiting VC in elderly patients without CKD, as well as for prevention of VC in patients with CKD. Nutritional vitamin D, such as cholecalciferol, may be considered to decrease the required dose of active vitamin D, which increases the risk of VC due to increased calcium and phosphate loads. Omega-3 fatty acids are important nutrients and their ability to inhibit VC needs to be evaluated in clinical trials. This review focuses on the ability of supplementary nutrients to prevent VC in patients with CKD, in whom dietary restriction is essential.

참고문헌 (Reference)

1 Saifan C, "Warfarin-induced calciphylaxis : a case report and review of literature" 6 : 665-669, 2013

2 Caluwe R, "Vitamin K2 supplementation in haemodialysis patients : a randomized dose-finding study" 29 : 1385-1390, 2014

3 Binkley NC, "Vitamin K nutrition and osteoporosis" 125 : 1812-1821, 1995

4 Cranenburg EC, "Vitamin K intake and status are low in hemodialysis patients" 82 : 605-610, 2012

5 Feskanich D, "Vitamin K intake and hip fractures in women : a prospective study" 69 : 74-79, 1999

6 Krueger T, "Vitamin K deficiency in CKD patients: a modifiable risk factor for vascular calcification?" 76 : 18-22, 2009

7 Bancha Satirapoj, "Very low protein diet plus ketoacid analogs of essential amino acids supplement to retard chronic kidney disease progression" 대한신장학회 37 (37): 384-392, 2018

8 Hayden MR, "Vascular ossification-calcification in metabolic syndrome, type 2 diabetes mellitus, chronic kidney disease, and calciphylaxis-calcific uremic arteriolopathy : the emerging role of sodium thiosulfate" 4 : 4-, 2005

9 An WS, "Vascular calcification score on plain radiographs of the feet as a predictor of peripheral arterial disease in patients with chronic kidney disease" 42 : 773-780, 2010

10 An WS, "Vascular calcification on plain radiographs is associated with carotid intima media thickness, malnutrition and cardiovascular events in dialysis patients : a prospective observational study" 14 : 27-, 2013

11 Goodman WG, "Vascular calcification in chronic kidney disease" 43 : 572-579, 2004

12 Vergnaud P, "Undercarboxylated osteocalcin measured with a specific immunoassay predicts hip fracture in elderly women : the EPIDOS Study" 82 : 719-724, 1997

13 Shroff RC, "The vascular biology of calcification" 20 : 103-109, 2007

14 Schafer C, "The serum protein alpha 2-Heremans-Schmid glycoprotein/fetuin-A is a systemically acting inhibitor of ectopic calcification" 112 : 357-366, 2003

15 Nestel P, "The n-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid increase systemic arterial compliance in humans" 76 : 326-330, 2002

16 Cranenburg EC, "The circulating inactive form of matrix Gla protein(ucMGP)as a biomarker for cardiovascular calcification" 45 : 427-436, 2008

17 Raggi P, "The ADVANCE study : a randomized study to evaluate the effects of cinacalcet plus low-dose vitamin D on vascular calcification in patients on hemodialysis" 26 : 1327-1339, 2011

18 Barril-Cuadrado G, "Table showing dietary phosphorus/protein ratio for the Spanish population. Usefulness in chronic kidney disease" 33 : 362-371, 2013

19 Pilkey RM, "Subclinical vitamin K deficiency in hemodialysis patients" 49 : 432-439, 2007

20 Hermans MM, "Study on the relationship of serum fetuin-A concentration with aortic stiffness in patients on dialysis" 21 : 1293-1299, 2006

21 Mehta RL, "Skin necrosis associated with acquired protein C deficiency in patients with renal failure and calciphylaxis" 88 : 252-257, 1990

22 Ogawa T, "Simple evaluation of aortic arch calcification by chest radiography in hemodialysis patients" 13 : 301-306, 2009

23 Tamashiro M, "Significant association between the progression of coronary artery calcification and dyslipidemia in patients on chronic hemodialysis" 38 : 64-69, 2001

24 Kovesdy CP, "Serum phosphorus and the risk of progression of chronic kidney disease" 22 : 3679-3680, 2007

25 Kestenbaum B, "Serum phosphate levels and mortality risk among people with chronic kidney disease" 16 : 520-528, 2005

26 Wu-Wong JR, "Role of phosphorus and vitamin D analogs in the pathogenesis of vascular calcification" 318 : 90-98, 2006

27 Booth SL, "Response of vitamin K status to different intakes and sources of phylloquinone-rich foods : comparison of younger and older adults" 70 : 368-377, 1999

28 Hruska KA, "Renal osteodystrophy, phosphate homeostasis, and vascular calcification" 20 : 309-315, 2007

29 김선철, "Relationship between pulmonary hypertension, peripheral vascular calcification, and major cardiovascular events in dialysis patients" 대한신장학회 34 (34): 28-34, 2015

30 Tonelli M, "Relation between serum phosphate level and cardiovascular event rate in people with coronary disease" 112 : 2627-2633, 2005

31 Ok E, "Reduction of dialysate calcium level reduces progression of coronary artery calcification and improves low bone turnover in patients on hemodialysis" 27 : 2475-2486, 2016

32 Russo D, "Pulse pressure and presence of coronary artery calcification" 4 : 316-322, 2009

33 Noordzij M, "Progression of aortic calcification is associated with disorders of mineral metabolism and mortality in chronic dialysis patients" 26 : 1662-1669, 2011

34 Verbeke F, "Prognostic value of aortic stiffness and calcification for cardiovascular events and mortality in dialysis patients : outcome of the calcification outcome in renal disease(CORD)study" 6 : 153-159, 2011

35 이자영, "Pre-existing arterial pathologic changes affecting arteriovenous fistula patency and cardiovascular mortality in hemodialysis patients" 대한내과학회 32 (32): 790-797, 2017

36 Ruiz-Gutierrez V, "Plasma lipids, erythrocyte membrane lipids and blood pressure of hypertensive women after ingestion of dietary oleic acid from two different sources" 14 : 1483-1490, 1996

37 Mirey Karavetian, "Patient education for hyperphosphatemia management: Improving outcomes while decreasing costs?" 대한신장학회 37 (37): 4-7, 2018

38 Block RC, "Omega-6 and trans fatty acids in blood cell membranes: a risk factor for acute coronary syndromes?" 156 : 1117-1123, 2008

39 An WS, "Omega-3 fatty acid supplementation increases 1, 25-dihydroxyvitamin D and fetuin-A levels in dialysis patients" 32 : 495-502, 2012

40 Block GA, "Mortality effect of coronary calcification and phosphate binder choice in incident hemodialysis patients" 71 : 438-441, 2007

41 Tukaj C, "Morphological changes of aortal smooth muscle cells exposed to calcitriol in culture" 6 : 668-674, 2000

42 Vossen LM, "Menaquinone-7 supplementation to reduce vascular calcification in patients with coronary artery disease : rationale and study protocol(VitaK-CAC Trial)" 7 : 8905-8915, 2015

43 Shanahan CM, "Medial localization of mineralization-regulating proteins in association with Monckeberg’s sclerosis : evidence for smooth muscle cell-mediated vascular calcification" 100 : 2168-2176, 1999

44 Amann K, "Media calcification and intima calcification are distinct entities in chronic kidney disease" 3 : 1599-1605, 2008

45 황은아, "Management of chronic kidney disease–mineral and bone disorder: Korean working group recommendations" 대한신장학회 34 (34): 4-12, 2015

46 Kalantar-Zadeh K, "Malnutrition-inflammation complex syndrome in dialysis patients : causes and consequences" 42 : 864-881, 2003

47 Theuwissen E, "Lowdose menaquinone-7 supplementation improved extra-hepatic vitamin K status, but had no effect on thrombin generation in healthy subjects" 108 : 1652-1657, 2012

48 Stenvinkel P, "Low fetuin-A levels are associated with cardiovascular death : impact of variations in the gene encoding fetuin" 67 : 2383-2392, 2005

49 Shinaberger CS, "Longitudinal associations between dietary protein intake and survival in hemodialysis patients" 48 : 37-49, 2006

50 Keelan PC, "Long-term prognostic value of coronary calcification detected by electron-beam computed tomography in patients undergoing coronary angiography" 104 : 412-417, 2001

51 Fox CS, "Kidney function is inversely associated with coronary artery calcification in men and women free of cardiovascular disease : the Framingham Heart Study" 66 : 2017-2021, 2004

52 Garneata L, "Ketoanalogue-supplemented vegetarian very low-protein diet and CKD progression" 27 : 2164-2176, 2016

53 Kidney Disease: Improving Global Outcomes (KDIGO)CKD-MBD Work Group, "KDIGO clinical practice guideline for the diagnosis, evaluation, prevention, and treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD)" 76 (76): S1-S130, 2009

54 Kidney Disease: Improving Global Outcomes (KDIGO)CKD-MBD Update Work Group, "KDIGO 2017 clinical practice guideline update for the diagnosis, evaluation, prevention, and treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD)" 7 : 1-59, 2017

55 Kidney Disease : Improving Global Outcomes(KDIGO)CKD Work Group, "KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease" 3 : 1-150, 2013

56 Hirata M, "In subtotally nephrectomized rats 22-oxacalcitriol suppresses parathyroid hormone with less risk of cardiovascular calcification or deterioration of residual renal function than 1, 25(OH)2 vitamin D3" 18 : 1770-1776, 2003

57 Kim OY, "Impact of blood or erythrocyte membrane fatty acids for disease risk prediction: focusing on cardiovascular disease and chronic kidney disease" 10 : E1454-, 2018

58 Jung JY, "Factors associated with aortic stiffness and its change over time in peritoneal dialysis patients" 25 : 4041-4048, 2010

59 Kanai S, "Eicosapentaenoic acid reduces warfarin-induced arterial calcification in rats" 215 : 43-51, 2011

60 Kim SJ, "Effects of low calcium dialysate on the progression of coronary artery calcification in hemodialysis patients : an open-label 12-month randomized clinical trial" 243 : 431-436, 2017

61 Oksa A, "Effects of longterm cholecalciferol supplementation on mineral metabolism and calciotropic hormones in chronic kidney disease" 31 : 322-329, 2008

62 임은수, "Effects of education on low-phosphate diet and phosphate binder intake to control serum phosphate among maintenance hemodialysis patients: A randomized controlled trial" 대한신장학회 37 (37): 69-76, 2018

63 Jwa-Kyung Kim, "Effects of Lowering Dialysate Calcium Concentrations on Arterial Stiffness in Patients Undergoing Hemodialysis" 대한내과학회 26 (26): 320-327, 2011

64 Westenfeld R, "Effect of vitamin K2 supplementation on functional vitamin K deficiency in hemodialysis patients : a randomized trial" 59 : 186-195, 2012

65 An WS, "Effect of omega-3 fatty acids on the modification of erythrocyte membrane fatty acid content including oleic acid in peritoneal dialysis patients" 86 : 29-34, 2012

66 Dogan E, "Effect of depot oral cholecalciferol treatment on secondary hyperparathyroidism in stage 3 and stage 4 chronic kidney diseases patients" 30 : 407-410, 2008

67 Schlemmer CK, "Ectopic calcification of rat aortas and kidneys is reduced with n-3fatty acid supplementation" 59 : 221-227, 1998

68 Helvig CF, "Dysregulation of renal vitamin D metabolism in the uremic rat" 78 : 463-472, 2010

69 Mizobuchi M, "Differential effects of vitamin D receptor activators on vascular calcification in uremic rats" 72 : 709-715, 2007

70 Geleijnse JM, "Dietary intake of menaquinone is associated with a reduced risk of coronary heart disease : the Rotterdam Study" 134 : 3100-3105, 2004

71 Schurgers LJ, "Determination of phylloquinone and menaquinones in food. Effect of food matrix on circulating vitamin K concentrations" 30 : 298-307, 2000

72 Chertow GM, "Determinants of progressive vascular calcification in haemodialysis patients" 19 : 1489-1496, 2004

73 진동찬, "Current characteristics of dialysis therapy in Korea: 2016 registry data focusing on diabetic patients" 대한신장학회 37 (37): 20-29, 2018

74 Russo D, "Coronary artery calcification in patients with CRF not undergoing dialysis" 44 : 1024-1030, 2004

75 An WS, "Comparison of fatty acid contents of erythrocyte membrane in hemodialysis and peritoneal dialysis patients" 19 : 267-274, 2009

76 Foley RN, "Clinical epidemiology of cardiovascular disease in chronic renal disease" 32 (32): S112-S119, 1998

77 Matias PJ, "Cholecalciferol supplementation in hemodialysis patients : effects on mineral metabolism, inflammation, and cardiac dimension parameters" 5 : 905-911, 2010

78 Garcia-Lopes MG, "Cholecalciferol supplementation in chronic kidney disease : restoration of vitamin D status and impact on parathyroid hormone" 61 : 74-82, 2012

79 Zheng CM, "Cholecalciferol additively reduces serum parathyroid hormone levels in severe secondary hyperparathyroidism treated with calcitriol and cinacalcet among hemodialysis patients" 10 : 2018

80 Zheng JQ, "Cholecalciferol additively reduces serum parathyroid hormone and increases vitamin D and cathelicidin levels in paricalcitol-treated secondary hyperparathyroid hemodialysis patients" 8 : E708-, 2016

81 Cranenburg EC, "Characterisation and potential diagnostic value of circulating matrix Gla protein(MGP)species" 104 : 811-822, 2010

82 Sokoll LJ, "Changes in serum osteocalcin, plasma phylloquinone, and urinary gamma-carboxyglutamic acid in response to altered intakes of dietary phylloquinone in human subjects" 65 : 779-784, 1997

83 이미정, "Changes in geriatric nutritional risk index and risk of major adverse cardiac and cerebrovascular events in incident peritoneal dialysis patients" 대한신장학회 36 (36): 377-386, 2017

84 Braam LA, "Beneficial effects of vitamins D and K on the elastic properties of the vessel wall in postmenopausal women : a follow-up study" 91 : 373-380, 2004

85 Nishizawa Y, "Atherosclerosis in uremia : possible roles of hyperparathyroidism and intermediate density lipoprotein accumulation" 62 : S90-, 1997

86 Shoji T, "Atherogenic lipoprotein changes in the absence of hyperlipidemia in patients with chronic renal failure treated by hemodialysis" 131 : 229-236, 1997

87 Booth SL, "Associations between vitamin K biochemical measures and bone mineral density in men and women" 89 : 4904-4909, 2004

88 안원석, "Associations between Oxidized LDL to LDL Ratio, HDL and Vascular Calcification in the Feet of Hemodialysis Patients" 대한의학회 24 : 115-120, 2009

89 Shoben AB, "Association of oral calcitriol with improved survival in nondialyzed CKD" 19 : 1613-1619, 2008

90 Kovesdy CP, "Association of activated vitamin D treatment and mortality in chronic kidney disease" 168 : 397-403, 2008

91 Son YK, "Association between vascular calcification scores on plain radiographs and fatty acid contents of erythrocyte membrane in hemodialysis patients" 22 : 58-66, 2012

92 Price PA, "Artery calcification in uremic rats is increased by a low protein diet and prevented by treatment with ibandronate" 70 : 1577-1583, 2006

93 Guerin AP, "Arterial stiffening and vascular calcifications in end-stage renal disease" 15 : 1014-1021, 2000

94 London GM, "Arterial media calcification in end-stage renal disease : impact on all-cause and cardiovascular mortality" 18 : 1731-1740, 2003

95 Blacher J, "Arterial calcifications, arterial stiffness, and cardiovascular risk in end-stage renal disease" 38 : 938-942, 2001

96 Nitta K, "Aortic arch calcification and clinical outcome in patients with end-stage renal disease" 223 : 79-84, 2011

97 Paganelli F, "Altered erythrocyte n-3 fatty acids in Mediterranean patients with coronary artery disease" 78 : 27-32, 2001

98 Lee SM, "Abdominal aortic calcification score among several vascular calcification scores of plain radiograph is the most reliable predictor of severe coronary artery calcification in dialysis patients" 39 : 729-735, 2017

99 Honkanen E, "Abdominal aortic calcification in dialysis patients : results of the CORD study" 23 : 4009-4015, 2008

100 Adragao T, "A simple vascular calcification score predicts cardiovascular risk in haemodialysis patients" 19 : 1480-1488, 2004

101 Wetmore JB, "A randomized trial of cinacalcet versus vitamin D analogs as monotherapy in secondary hyperparathyroidism(PARADIGM)" 10 : 1031-1040, 2015

102 Adragao T, "A plain X-ray vascular calcification score is associated with arterial stiffness and mortality in dialysis patients" 24 : 997-1002, 2009

103 Hall WL, "A high-fat meal enriched with eicosapentaenoic acid reduces postprandial arterial stiffness measured by digital volume pulse analysis in healthy men" 138 : 287-291, 2008

104 Henley C, "1, 25-Dihydroxyvitamin D3 but not cinacalcet HCl(Sensipar/Mimpara)treatment mediates aortic calcification in a rat model of secondary hyperparathyroidism" 20 : 1370-1377, 2005