He referred to this mystery nutrient as activator X. Its now believed to have been vitamin K2 (1). When you think of strong and healthy bones, you may be tempted to think of calcium as the main nutrient to prevent fractures and osteoporosis. Blood thats too thin can make you bruise more easily and even leave you at risk for dangerous internal bleeding. Researchers have speculated that vitamin K2 may affect dental health. Think of oranges, grapefruits, limes and lemons. [86], performed a study with an open-label placebo-controlled design in a population of 102 maintenance HD patients, and found that daily intake of 200 g MK-7 for one year decreased circulating ucMGP levels by 46% while having no effect on the progression of VC as assessed by Agatston score of the abdominal aorta. Some early research has shown that vitamin K2 may be more effective at clearing out calcium than vitamin K1. A meta-analysis by Lees et al. Temmar M., Liabeuf S., Renard C., Czernichow S., Esper N.E., Shahapuni I., Presne C., Makdassi R., Andrejak M., Tribouilloy C., et al. Proper Calcium Use: Vitamin K 2 as a Promoter of Bone and But thats not a hard-and-fast rule. Therefore, in RCTs investigating the effect of vitamin K on CKD patients vitamin D status should be always assessed and corrected at baseline [97]. We want to have enough K2 around all the time to be sure that we can activate the Vitamin K dependent proteins that are so critical for healthy bones, osteocalcin, which puts calcium into our bones and matrix gla protein which prevents calcium from depositing where we don't want it, in our vasculature, arteries, heart, breasts, brain, and . Compared to the general population, the prevalence of arterial microcalcification is 45 times greater in CKD patients [10]. HHS Vulnerability Disclosure, Help The carboxylation of Glu causes significant alterations in the molecular structure of VKDPs, leading to their activation. However, more studies on the roles of vitamin K subtypes are needed. Other supplements like vitamin K2 (VitK2) and magnesium (Mg) could contribute to the maintenance of skeletal health. In other studies, circulating K1 in serum or plasma was assessed; however, levels of K1 are highly dependent on lipids and lipoproteins, and do not reflect the levels of K2. Both are. We do not endorse non-Cleveland Clinic products or services. Munroe P.B., Olgunturk R.O., Fryns J.P., Van Maldergem L., Ziereisen F., Yuksel B., Gardiner R.M., Chung E. Mutations in the gene encoding the human matrix Gla protein cause Keutel syndrome. 1 / 55 Flashcards Learn Test Match Created by deserrae_potts8 Terms in this set (55) fat soluble viatmins A, D, E, K Water soluble vitamins B and C major mineral a mineral that you need in the amount of 100 mg or more a day trace minerals we require less than 100 mg of these per day Sabrina-Wong-Peixin Haroon B.-C., Tai L.-H.L., Lynette Teo A.D., Leon Schurgers B.-W.T., Priyanka Khatri C.-C.O., Sanmay Low X.-E.Y., Jia-Neng Tan S.S., Horng-Ruey Chua S.-Y.T., Weng-Kin Wong T.-W.-L. showed that in a cohort of 37 HD patients dp-ucMGP was an independent predictor of arterial stiffness and endothelial dysfunction as assessed by PWV and flow mediated dilation, respectively, even after adjustment for duration of dialysis, gender, age, diabetes, blood pressure, and history of CV disease [71]. Bostrom K., Tsao D., Shen S., Wang Y., Demer L.L. Based on animal studies and the role vitamin K2 plays in bone metabolism, its reasonable to assume that this nutrient affects dental health as well. Hortells L., Sosa C., Guillen N., Lucea S., Millan A., Sorribas V. Identifying early pathogenic events during vascular calcification in uremic rats. Vitamin K, particularly as vitamin K 2, is nearly nonexistent in junk food, with little being consumed even in a healthy Western diet. But lets focus here on bone health. However, deficiencies of both K1 and K2 appear to have a negative effect. Currently, there is keen scientific interest on the potential clinical role of vitamin K in the pathogenesis and development of arterial calcification and stiffness in CKD and ESKD. Moreover, the K and D group presented a non-statistically significant improvement in coronary calcification score, which was even more pronounced when the authors removed from the statistical analysis four patients with markedly increased calcification scores. Vitamins D and K are both fat-soluble vitamins that play a crucial role in bone and heart health (3,4). The ratio of Ca to P should never drop below 1.2 : 1 and vitamin D must also be available. Vitamin K is used to reduce the risk of bleeding in liver disease. Thats because of the way it acts to clear out calcium from your blood vessels. Even in early stages of CKD, calcification of the media or intima is present in 5090% of all cases [11] and the prevalence and degree of VC are more increased in ESKD. What are vitamin D and calcium? After 1.5 years of treatment, MK-7 failed to show any beneficial effect on various markers of VC and stiffness, including PWV, coronary artery calcification score, and calcification of the cardiac valves. Roumeliotis S., Roumeliotis A., Dounousi E., Eleftheriadis T., Liakopoulos V. Vitamin K for the treatment of cardiovascular disease in End-Stage Renal Disease patients: Is there hope? Furthermore, vitamin K can help the body pull calcium into the bones and teeth something that vitamin D cannot do. Bone biomarkers help grading severity of coronary calcifications in non dialysis chronic kidney disease patients. NTS135: Unit 3 - Chapters 8 - 13 Flashcards | Quizlet At this point, researchers have yet to determine if vitamin K1 or vitamin K2 are equally responsible for clotting or if one is any more effective than the other when it comes to blood clotting. Vitamin K exists in three vitamers, phylloquinone (or K1), menaquinone (K2), and menadione (K3); there are several sub-forms of K2 depending on the number of isoprenyl units and the length of the side-chain. Interestingly, several studies have been done on vitamin K2 and certain types of cancer. J. Kidney Dis. These two studies showed that even 460 g of vitamin K2 per day failed to restore vitamin K status (as reflected by the reduction rate of dp-ucMGP) in dialysis patients, and provided the rationale for designing randomized controlled trials (RCTs) in dialysis patients. Vitamin K has long been known to play an important role in blood clotting. Vitamin D and calcium are essential for healthy bones and other bodily functions, so following consumption guidelines is crucial. Vitamin K2 can play a role in blood clotting, heart health, and bone health. However, current evidence indicates that the conversion process is inefficient. Vitamin A and D appear to work together and both may be involved in the communication between cells, especially those cells involved in calcium regulation via vitamin K-dependent proteins. The Vitamin K2 Supplementation and Arterial Stiffness in the Renal Transplant Population (KING) trial [82] was a single-arm, single-center, interventional clinical trial in 60 stable kidney transplant recipients. Brandenburg V.M., DHaese P., Deck A., Mekahli D., Meijers B., Neven E., Evenepoel P. From skeletal to cardiovascular disease in 12 steps-the evolution of sclerostin as a major player in CKD-MBD. In these populations, dp-ucMGP reflects poor vitamin K status and is significantly reduced with vitamin K2 (especially MK-7) supplementation. May help improve bone health and lower your risk of osteoporosis. Vitamin K status, supplementation and vascular disease: A systematic review and meta-analysis. However, three decades ago this perspective changed significantly and it became evident that the calcification of arteries is not a degenerative but rather an active process starting with the osteoblastic differentiation of vascular smooth muscle cells (VSMCs) [14], a process similar to bone formation. Understanding the role of this vitamin (and where to find it!). However, more high quality studies are needed before any strong claims can be made. Nutrition exam 3 Flashcards | Quizlet Only after hepatic vitamin K requirement has been met, the excess vitamin K is transported to extra-hepatic tissues. Zebboudj A.F., Imura M., Bostrom K. Matrix GLA protein, a regulatory protein for bone morphogenetic protein-2. Theres still much to be understood about the differences between vitamin K1 and vitamin K2, and research is ongoing. One of its most important functions is to regulate calcium deposition. While the daily recommended amount of vitamin K for healthy subjects is 90120 g [78], the exact dosage of vitamin K intake for activation of MGP in populations with vitamin K deficiency, such as CKD patients, has not yet been defined. Hu M.C., Shi M., Zhang J., Quiones H., Griffith C., Kuro-o M., Moe O.W. Dal Canto E., Beulens J.W., Elders P., Rutters F., Stehouwer C.D., van der Heijden A.A., van Ballegooijen A.J. Vitamin K1 is found primarily in green, leafy and cruciferous vegetables. Moreover, a very recent randomized interventional non-placebo, controlled trial was performed in 60 ESKD children undergoing maintenance HD, who were randomized to receive 100 g of MK-7 or 10 g of native vitamin D, a combination of both, or standard care (no vitamins) every day for four months; the results showed that when compared to the other groups those who received the combination of both vitamins presented the highest reduction in dp-ucMGP [96]. The main drawbacks of this study were its small sample size and high drop-out rate; of 641 patients originally assessed, 48 only were enrolled and only 21 ultimately completed the trial. Finally, at baseline the vitamin K group had increased proteinuria compared to the placebo group (12 versus < 3 mg/mmol) and higher prevalence of both diabetes (28.9% versus 15.6%) and CV disease (peripheral arterial disease was present at 6.7% versus 0%, heart failure was present at 6.7% versus 0%, ischemic heart disease at 37.8% versus 26.7%, and ischemic attack or stroke was 4.4% versus 2.2%), whereas all participants at baseline presented extended VC. 1Division of Nephrology and Hypertension, 1st Department of Internal Medicine, AHEPA Hospital, School of Medicine, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; moc.liamtoh@sitoilemuor_ts (S.R. Skip Navigation COVID-19 Updates New masking guidelinesare in effect starting April 24. High Dephosphorylated-Uncarboxylated MGP in Hemodialysis patients: Risk factors and response to vitamin K2, A pre-post intervention clinical trial. Zebboudj A.F., Shin V., Bostrom K. Matrix GLA protein and BMP-2 regulate osteoinduction in calcifying vascular cells. Nagata Y., Inaba M., Imanishi Y., Okazaki H., Yamada S., Mori K., Shoji S., Koyama H., Okuno S. Increased undercarboxylated osteocalcin/intact osteocalcin ratio in patients undergoing hemodialysis. Roijers R.B., Debernardi N., Cleutjens J.P., Schurgers L.J., Mutsaers P.H., van der Vusse G.J. 10.1016/j.maturitas.2020.05.020 Abstract Supplementation with calcium (Ca) and/or vitamin D (vitD) is key to the management of osteoporosis. After all, blood clots can travel to your brain and cause strokes. However, this nutrient offers many other notable advantages to our health, as a proper intake is essential for: Building and maintenance of strong bones Dental health Cardiovascular function Regulation of blood pressure Taking magnesium with other vitamins and minerals Whats in a name? Nigwekar S.U., Bloch D.B., Nazarian R.M., Vermeer C., Booth S.L., Xu D., Thadhani R.I., Malhotra R. Vitamin K-Dependent Carboxylation of Matrix Gla Protein Influences the Risk of Calciphylaxis. Luo G., Ducy P., McKee M.D., Pinero G.J., Loyer E., Behringer R.R., Karsenty G. Spontaneous calcification of arteries and cartilage in mice lacking matrix GLA protein. Interventional studies of the effects of Vitamin K supplementation on arterial calcification and stiffness in CKD and ESKD. Seven interventional clinical studies have published results on CKD and ESKD populations thus far: two in predialysis CKD patients, two in kidney transplant recipients, and three in dialysis patients (two only in HD, and one in a mixed dialysis population of both PD and HD patients). By activating VKDPs, vitamin K (a group of fat-soluble vitamins) is implicated in the regulation of bone metabolism, blood coagulation, and vascular health. INTRODUCTION. Pulse wave velocity and vascular calcification at different stages of chronic kidney disease. The impact of vitamin K2 and native vitamin D supplementation on vascular calcification in pediatric patients on regular hemodialysis. But if youre looking to add more vitamin K2 to your diet, know that some of the top sources of vitamin K-rich foods arent ones we typically see as part of a healthy diet. Oneill W.C., Lomashvili K.A. In controlled studies in people, researchers have also observed that vitamin K2 supplements generally improve bone and heart health, while vitamin K1 has no significant benefits (4). Thamratnopkoon S., Susantitaphong P., Tumkosit M., Katavetin P., Tiranathanagul K., Praditpornsilpa K., Eiam-Ong S. Correlations of Plasma Desphosphorylated Uncarboxylated Matrix Gla Protein with Vascular Calcification and Vascular Stiffness in Chronic Kidney Disease. Likewise, in another cross-sectional study that enrolled 83 patients in CKD stages 3 to 5, dp-ucMGP was augmented according to CKD severity [66]. Eren P.A., Turan K., Berber I., Canbakan M., Kara M., Tellioglu G., Bugan U., Sevinc C., Turkmen F., Titiz M.I. Vitamin K2 is gaining recognition for its effects on blood clotting, heart health and bone health. But a certain amount of clotting-ability in your blood is important for your health. The adverse events that have been recorded are very mild and mostly include gastrointestinal symptoms, and toxicity has never been reported. People taking blood-thinning drugs, such as warfarin (Coumadin), should not take vitamin K without consulting their doctor because vitamin K can reverse the effects of these drugs. Morena M., Jaussent I., Halkovich A., Dupuy A.M., Bargnoux A.S., Chenine L., Leray-Moragues H., Klouche K., Vernhet H., Canaud B., et al. Neradova A., Schumacher S., Hubeek I., Lux P., Schurgers L., Vervloet M. Phosphate binders affect vitamin K concentration by undesired binding, an in vitro study. ; methodology, A.D., V.V. The biggest study to date was conducted by Puzantian et al. Most of us arent consuming enough of the foods rich in this vitamin to support our health. If you buy through links on this page, we may earn a small commission Heres our process. Vitamin D and calcium work together to slow down or even reverse osteoporosis. The numbers in the parentheses (1, 2, 3) are clickable links to peer-reviewed scientific papers. Schurgers et al. It should be noted that the mean age of the patients included in the K2 group was 79.6 years, and therefore the excessive calcification of arteries at this age may not be amenable to any reversal strategy. For instance, some calcium supplements may also contain vitamin D or magnesium. Vitamin K isnt unique in this regard. Vitamin K has been shown to help activate a protein that helps prevent calcium from depositing in your arteries, Zumpano explains. This was one of the first interventional studies in this research area to highlight the synergy and interaction between vitamins K and D; however, the small sample size, the short study period, and the low MK-7 dosage should be acknowledged as limitations. Keyzer C.A., Vermeer C., Joosten M.M., Knapen M.H., Drummen N.E., Navis G., Bakker S.J., de Borst M.H. In agreement with these results, Kayzer et al., enrolled 518 stable kidney transplant recipients, followed them for a median period of 9.8 years, and found that increased plasma dp-ucMGP was an independent predictor of all-cause mortality and transplant failure [77]. At baseline, 53% of the recruited patients presented with subclinical vitamin K deficiency and exogenous supplementation of MK-7 (360 g/day for two months), which was accompanied by a 14.2% improvement in vascular stiffness as assessed by the change in carotid-femoral PWV. While food safety organizations in parts of Asia and Europe officially acknowledge some health benefits of vitamin K, the U.S. Food and Drug Administration (FDA) hasnt authorized a health claim for vitamin K. Essentially, that means more research needs to be done for the FDA to back vitamin K as a significant contributor to health. Although the majority of published or ongoing trials in CKD or ESKD population have adopted a daily dosage of 200500 g of vitamin K2, two new RCTs registered on clinicaltrials.gov, the VIKIPEDIA and the UCASAL-VITK studies, propose higher daily dosages of vitamin K. The VIKIPEDIA study will assess the effect of 1000 g/day of MK-7 on arterial stiffness and CV disease in PD patients, whereas the UCASAL-VITK link will investigate whether intravenous supplementation with MK-7 2000 g thrice weekly can improve markers of VC in a cohort of maintenance HD patients. However, it's believed that these two . In CKD, all these patterns might occur either alone or in combination, and the degree of VC progressively increases along with disease deterioration to ESKD [8,9]. and transmitted securely. What To Know About Vitamin K2 and Its Health Benefits, Study: High-Dose Vitamin D Does Not Prevent Heart Disease. There are some foods that are both naturally healthy and rich in vitamin K2.. This article originally appeared in Cleveland Clinic Arthritis Advisor. Vitamin K1 is involved in blood coagulation, and vitamin K2 benefits bone and heart health. Our team thoroughly researches and evaluates the recommendations we make on our site. Accessibility This study expands our understanding, provides novel insights into vitamin K metabolism in uremia, and suggests that altered uptake and transportation of vitamin K by lipoproteins in advanced CKD might be another mechanism (besides reduced vitamin K intake) underlying the poor vitamin K status of HD patients. Vitamin K1 is most useful for your body when its eaten in its natural form. The .gov means its official. Zeng C., Guo C., Cai J., Tang C., Dong Z. Serum sclerostin in vascular calcification and clinical outcome in chronic kidney disease. Two clinical studies suggest that vitamin K2 reduces the recurrence of liver cancer and increases survival times (19, 20). The 6 Best Calcium Supplements of 2023 - Verywell Health Inclusion in an NLM database does not imply endorsement of, or agreement with, Currently-ongoing interventional RCTs regarding vitamin K supplementation in these populations include the Inhibit Progression of Coronary Artery Calcification with Vitamin K1 in Hemodialysis participants (iPACK-HD) [89], Treatment to Reduce Vascular Calcification in Hemodialysis Patients Using Vitamin K (TReVasc-HDK) [90], Vitamin K1 to Slow Progression of Vascular Calcification in HD Patients (VitaVasK) [91], Vitamin K to Slow Progression of Cardiovascular Disease Risk in Hemodialysis Patients (Vita-K n CKD, registered on clinicaltrials.gov, reference number {"type":"clinical-trial","attrs":{"text":"NCT03311321","term_id":"NCT03311321"}}NCT03311321), Universidad Catlica de Salta-Vitamin K2 Supplementation and Vascular Calcification (UCASAL-VITK, registered on clinicaltrials.gov with reference number {"type":"clinical-trial","attrs":{"text":"NCT04539418","term_id":"NCT04539418"}}NCT04539418 and the first to assess intravenous supplementation of MK-7 in HD patients), and the Vitamin K in Peritoneal Dialysis (VIKIPEDIA) study, the first to assess MK-7 supplementation in PD (registered on clinicaltrials.gov, reference number {"type":"clinical-trial","attrs":{"text":"NCT04900610","term_id":"NCT04900610"}}NCT04900610). Off. So far, results have been mixed. All Rights Reserved. That makes vitamin K . Abstract The K vitamins, a group of napthoquinones, are required for the carboxylation of a limited number of proteins including the bone matrix protein osteocalcin. Having low levels of vitamin K is associated with a higher risk of bone fractures, Zumpano notes. Roumeliotis S., Roumeliotis A., Stamou A., Leivaditis K., Kantartzi K., Panagoutsos S., Liakopoulos V. The Association of dp-ucMGP with Cardiovascular Morbidity and Decreased Renal Function in Diabetic Chronic Kidney Disease. Facts About Vitamin D, Calcium, and Fractures Vitamin D and calcium are essential nutrients that are important to overall health. Research shows that the two of them together may be more effective for bone . In the words of Goldilocks, it keeps your blood just right. The importance of this study was that it showed for the first time that supplementation with vitamin K might prevent or even reverse VC. Vitamin K: the effect on health beyond coagulation - an overview Holden R.M., Booth S.L., Day A.G., Clase C.M., Zimmerman D., Moist L., Shea M.K., McCabe K.M., Jamal S.A., Tobe S. Inhibiting the progression of arterial calcification with vitamin K in HemoDialysis patients (iPACK-HD) trial: Rationale and study design for a randomized trial of vitamin K in patients with end stage kidney disease. The authors declare no conflict of interest. Despite the short period of treatment, this study produced positive results; however, the outcome was the change in a surrogate marker of arterial stiffness, not a hard clinical endpoint. Although the reduction in dp-ucMGP was significantly higher in the rivaroxaban group and even higher in the rivaroxaban plus K group, at the end of the study circulating dp-ucMGP levels in this group remained high. the contents by NLM or the National Institutes of Health. The few controlled studies that have been conducted used vitamin K1, which seems to be ineffective (9). The body also needs vitamin C to produce collagen. Vitamin K supplementation for the prevention of cardiovascular disease: Where is the evidence? dp-ucMGP was an independent predictor of mortality in 188 maintenance HD patients [72]. Eight out of ten HD patients present with VC, which is tightly correlated with the duration of dialysis [12]; every year on dialysis confers a 15% increased risk of developing calcification of the coronary arteries [13]. Secondary (or sub-clinical) vitamin K deficiency would then form an increased risk factor for accelerated bone loss, vascular calcification, and cancer. ), 2Department of Nephrology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; moc.oohay@inudtsirkina (A.D.); moc.liamtoh@sostikht (A.K.). Publishers Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. and E.D. In one study spanning 7-10 years, people with the highest intake of vitamin K2 were 52% less . Your bones need vitamin K. But our rheumatologist explains why you probably get enough from your diet. Rennenberg R., Kessels A., Schurgers L., Van Engelshoven J., De Leeuw P., Kroon A. Vascular calcifications as a marker of increased cardiovascular risk: A meta-analysis. That means it stays in your body longer several days even and has more time to do its good work. Morena M., Jaussent I., Dupuy A.M., Bargnoux A.S., Kuster N., Chenine L., Leray-Moragues H., Klouche K., Vernhet H., Canaud B., et al. Vitamin K1 to slow vascular calcification in haemodialysis patients (VitaVasK trial): A rationale and study protocol. There are four distinct histopathologic patterns of arterial calcification: calcification of the intima, calcification of the media, calcification of cardiac valves, and calciphylaxis. Although maintaining optimal levels of vitamin D is highly important for the function of vitamin K, this issue has been repeatedly overlooked or neglected in several interventional . Now you may wonder: what are the benefits of taking calcium and vitamin K2 together? Vitamin K can help keep your blood not too thick and not too thin. One study found that people who took in at least 32 micrograms per day of vitamin K2 in their diet were 50% less likely to die from heart disease related to hardened arteries. In addition, some calcium supplements are combined with vitamins and other minerals. Thats why FuelOrganics offers a high-quality vegan vitamin K2 supplement designed for anyone looking to support a healthy heart and bones. Therefore, while the fully inactive form of MGP is the dephosphorylated, uncarboxylated MGP (dp-ucMGP) MGP exists in the partially inactive forms of dephosphorylated carboxylated MGP (dp-cMGP) and phosphorylated uncarboxylated MGP (p-ucMGP) as well. Calcium and P are very important for lactating does and growing kids. and A.K. In other words, it promotes the calcification of bones and prevents the calcification of blood vessels and kidneys (3). But in reality, vitamin D, vitamin K and calcium all actually work together.. In pre-dialysis CKD, data from a few observational studies showed that dp-ucMGP was associated with various surrogate markers of arterial calcification or stiffness. Zumpano details what we do know about K vitamins, and vitamin K2 specifically, including some of its most important benefits. Some scientists have suggested that the roles of vitamins K1 and K2 are quite different, and many feel that they should be classified as separate nutrients altogether. Vitamin K2 plays an essential role in bone metabolism, and studies suggest that it can help prevent osteoporosis and fractures. Similarly, in a group of 66 patients with diabetic CKD circulating dp-ucMGP was associated with CV morbidity, mortality, and deterioration of kidney function [50,76]. They require a Ca:P . Several widely available foods are rich sources of vitamin K1, but vitamin K2 is less common. found that ucMGP was associated with duration of dialysis and aortic augmentation index [70]. Foods we can add to our diet that are rich sources of calcium include: Those not receiving enough calcium from our diet may need to take daily calcium supplements to avoid a deficiency in this nutrient. Kaesler N., Magdeleyns E., Herfs M., Schettgen T., Brandenburg V., Fliser D., Vermeer C., Floege J., Schlieper G., Kruger T. Impaired vitamin K recycling in uremia is rescued by vitamin K supplementation. El Borolossy R., El-Farsy M.S. In contrast to the other VKDPs, after -carboxylation GP needs to undergo another activation step, phosphorylation of its serine residues, which again requires vitamin K as a co-factor. Vitamin K is a group of nutrients divided into vitamins K1 and K2. Combine vitamin D and vitamin K correctly - VitaminExpress Nitta K., Akiba T., Uchida K., Kawashima A., Yumura W., Kabaya T., Nihei H. The progression of vascular calcification and serum osteoprotegerin levels in patients on long-term hemodialysis. One of the main regulating proteins in dental health is osteocalcin the same protein that is critical to bone metabolism and is activated by vitamin K2 (16). Vitamin K supplements are relatively safe, and many people take them. Vitamin D plays a role in reducing inflammation and assisting in cell growth and immune function (4). All rights reserved. Combination Vitamin D3 and K2: Game Changing Benefits - HumanN Levy-Schousboe K., Frimodt-Mller M., Hansen D., Peters C.D., Kjrgaard K.D., Jensen J.D., Strandhave C., Elming H., Larsen C.T., Sandstrm H. Vitamin K supplementation and arterial calcification in dialysis: Results of the double-blind, randomised, placebo-controlled RenaKvit trial. The Role of Vitamin D One of the main functions of vitamin D is to maintain adequate.