You what?

[cassandra]

So I found this, while searching for info on vitamin B3 in hemo patients (vit.B3 might lower phosphate in HD patients)
 
 
US National Library of Medicine National Institutes of Health
Am J Kidney Dis. 2012 Feb;59(2):186-95. doi: 10.1053/j.ajkd.2011.10.041. Epub 2011 Dec 9.
Effect of vitamin K2 supplementation on functional vitamin K deficiency in hemodialysis patients: a randomized trial.
Westenfeld R1, Krueger T, Schlieper G, Cranenburg EC, Magdeleyns EJ, Heidenreich S, Holzmann S, Vermeer C, Jahnen-Dechent W, Ketteler M, Floege J, Schurgers LJ.
Author information
Abstract

BACKGROUND:
Vascular calcification is a predictor of cardiovascular morbidity and mortality. Hemodialysis patients experience severe vascular calcifications. Matrix Gla protein (MGP) is a central calcification inhibitor of the arterial wall; its activity depends on vitamin K-dependent γ-glutamate carboxylation. Uncarboxylated MGP, formed as a result of vitamin K deficiency, is associated with cardiovascular disease. Recent studies suggest poor vitamin K status in hemodialysis patients. We therefore aimed to investigate whether daily vitamin K supplementation improves the bioactivity of vitamin K-dependent proteins in hemodialysis patients, assessed by circulating dephosphorylated-uncarboxylated MGP, uncarboxylated osteocalcin, and uncarboxylated prothrombin (PIVKA-II [protein induced by vitamin K absence II]).

STUDY DESIGN:
Interventional randomized non-placebo-controlled trial with 3 parallel groups.
SETTING & PARTICIPANTS:
53 long-term hemodialysis patients in stable conditions, 18 years or older. 50 healthy age-matched individuals served as controls.
INTERVENTIONS:
Menaquinone-7 (vitamin K(2)) treatment at 45, 135, or 360 μg/d for 6 weeks.
OUTCOMES:
Plasma levels of dephosphorylated-uncarboxylated MGP, uncarboxylated osteocalcin, and PIVKA-II.
MEASUREMENTS:
Plasma levels were assessed using enzyme-linked immunosorbent assays.

RESULTS:
At baseline, hemodialysis patients had 4.5-fold higher dephosphorylated-uncarboxylated MGP and 8.4-fold higher uncarboxylated osteocalcin levels compared with controls. PIVKA-II levels were elevated in 49 hemodialysis patients. Vitamin K(2) supplementation induced a dose- and time-dependent decrease in circulating dephosphorylated-uncarboxylated MGP, uncarboxylated osteocalcin, and PIVKA-II levels. Response rates in the reduction in dephosphorylated-uncarboxylated MGP levels were 77% and 93% in the groups receiving 135 μg and 360 μg of menaquinone-7, respectively.

LIMITATIONS:
Small sample size.

CONCLUSIONS:
This study confirms that most hemodialysis patients have a functional vitamin K deficiency. More importantly, it is the first study showing that inactive MGP levels can be decreased markedly by daily vitamin K(2) supplementation. Our study provides the rationale for intervention trials aimed at decreasing vascular calcification in hemodialysis patients by vitamin K supplementation.

TRIAL REGISTRATION:
ClinicalTrials.gov NCT01407601.
Copyright © 2012 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.
Comment in

[cassandra]

And I found in an other article that Gouda cheese, and Brie are high in K2. Natto too of course, but I prefer cheese (with binders)

The negatives are blood clotting though 

[Simon Dog]

More importantly, it is the first study showing that inactive MGP levels can be decreased markedly by daily vitamin K(2) supplementation. Our study provides the rationale for intervention trials aimed at decreasing vascular calcification in hemodialysis patients by vitamin K supplementation.

Interesting.   One of my docs saw "calcium acetate" and prescribed 100mg K2 daily.

[cassandra]

Wow, I like your doc.

   


Love, Cas

[kickingandscreaming]

I had been taking (on my own) K2 supplement.  My renal nutritionist suggested it might be problematic as it is fat soluble and therefore might be hard to regulate with bad/no kidneys.  I stopped taking them.  Don't know if this applies to PD folks also, or just hemo.

[cassandra]

The regulation bit of all fat soluble vits is problematic in all forms of D I think (apart from a transplant) Both PD and HD are 'waterbased' so can't remove fat or things like vitamins in fat. So maybe it's poss to have too much vit K2, like I was informed by a Dr to be carefull with fishoil as it could accumulate in the body. So I reduced, and than forgot. I'll start that one again too. I'll see to find something about vit K2 accumulation.

[Simon Dog]

My neph has approved the 3000ml fish oil qd and 100mg K2 q2 prescribed by another MD.

[Charlie B53]

When I took niacin I also took aspirin to reduce flushing, and fish oil.  The combination reduced clotting so bad my arms were constantly bruised or bleeding.  I would have to tear off strips of paper towel and fold them at least four layers and apply direct pressure sometimes up to an hour to stop bleeding.  After far to many years I did gouge my leg bleeding far more than I thought safe.  An hour drive to the ER and of course it had stopped.  They didn't even stitch it, slapped a big wimp sticker (bandage) on and sent me home.

I quit the niacin, aspirin,, and fish oil.  I clot normally not.   I was seriously worried 'What IF' as if I had a serious accident.  Even a car crash.  The seat belt could cause internal bleeding and killed me long before an ambulance could get there.

I do take the renal vitamin but have to wonder if it is enough of everything I need.

[KatieV]

I was taking Niacinamide - which supposedly doesn't have the flushing problem of Niacin - to help with my phosphate control.  Last month, my platelet count dropped very low.  Niacinamide can cause that to happen, so they told me to stop taking it.  A recheck of the platelets the next day showed a low, but not a crazy low like the day before, number, so it could have been a faulty result.  I am still off it for now.   

I would rather take something like Niacinamide than those nasty binders!  I'm hoping my labs are better this month after being back on NxStage for 2 months.

[cassandra]

Thanks for the info all. I'll order the K2 tomorrow, and increase the vit B3 from 50 to 70 mcg/day (nurse called that Dr okayed it)

Love to y'all, Cas

[Rerun]

I take some sort of Renal vitamin so I hope that helps. 

             

[Simon Dog]

When I took niacin I also took aspirin to reduce flushing, and fish oil.

I had severe thrombocytopenia (platelets down to 12), along with a sharp decline in residual and failure of pd to get adequate clearance due to the loss of residual.   The eventual probable cause was the 3000mg Niacin (Niaspan).    My problem went away after distontinuing the Niacin (I still take 81mg asprin).

[cassandra]

When I took niacin I also took aspirin to reduce flushing, and fish oil.

I had severe thrombocytopenia (platelets down to 12), along with a sharp decline in residual and failure of pd to get adequate clearance due to the loss of residual.   The eventual probable cause was the 3000mg Niacin (Niaspan).    My problem went away after distontinuing the Niacin (I still take 81mg asprin).

Niaspan is an extended release Niacin, and I've only increased my 'normal niacin' from 30 mcg ( in vitamin B compound) to 50 mcg and from today 70 mcg a day. Niaspan is also contra-indicated to people with a kidney impairment. But thanx for the warning Simon.