Korean J Intern Med.  2019 May;34(3):459-469. 10.3904/kjim.2019.125.

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

• Lee SM
• An WS

• KMID: 2448337
• DOI: http://doi.org/10.3904/kjim.2019.125

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 Kâ‚‚, 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.

Keyword

Vascular calcification; Renal insufficiency, chronic; Cholecalciferol; Vitamin K 2; Fatty acids, omega-3

MeSH Terms

Aged
Aging
Calcium
Cardiovascular Diseases
Cholecalciferol
Dialysis
Diet
Education
Fatty Acids, Omega-3
Humans
Malnutrition
Renal Insufficiency, Chronic*
Vascular Calcification*
Vitamin D
Vitamin K 2
Vitamins
Calcium
Cholecalciferol
Fatty Acids, Omega-3
Vitamin D
Vitamin K 2
Vitamins