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Publisher: Peytchinski Publishing Ltd.
ISSN: 1312-773X (Online)
Issue: 2026, vol. 32, issue1
Subject Area: Medicine
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DOI: 10.5272/jimab.2026321.6760
Published online: 25 March 2026
Original article
J of IMAB. 2026 Jan-Mar;32(1):6760-6764
VITAMIN K2 STATUS IN PATIENTS WITH PRE-DIALYSIS CHRONIC KIDNEY DISEASE
Tatyana Simeonova1
, Borislav Ignatov1, Anna Tolekova1, Tsvetelina Eftimova2, Alexander Blazhev3, Krasimir Kostov1,
1) Department of Physiology and Pathophysiology, Faculty of Medicine, Medical University – Pleven, Bulgaria.
2) Department of Dialysis, University Hospital "Saint Marina" – Pleven, Bulgaria.
3) Department of Biology, Medical University – Pleven, Bulgaria.
ABSTRACT:
Vitamin K2 plays a key role in calcium homeostasis through activation of VKDP, including matrix Gla protein, a potent inhibitor of vascular calcification. Impaired vitamin K2 status results in increased circulating levels of inactive dephosphorylated uncarboxylated MGP (dp-ucMGP), which serves as a marker for vitamin K2 deficiency. CKD patients are at particularly high risk of vitamin K2 deficiency and its related complications.
Purpose: To assess vitamin K2 status indirectly by measuring plasma dp-ucMGP levels in patients with pre-dialysis CKD.
Material/Methods: This cross-sectional study included 71 adult Caucasian patients with pre-dialysis CKD stages G1–G4, classified according to KDIGO criteria. Participants were divided into three groups based on estimated glomerular filtration rate (eGFR). Serum creatinine, calcium, inorganic phosphate, and plasma dp-ucMGP levels were measured. Statistical analyses were performed using appropriate parametric and non-parametric tests.
Results: Significant differences were observed among the groups in age, renal function parameters, serum calcium, and phosphate levels (p < 0.05). Plasma dp-ucMGP concentrations did not differ significantly between CKD stages. However, when compared with recalculated reference values reported in the literature, dp-ucMGP levels in all groups were elevated, suggesting functional vitamin K2 deficiency. Sex-specific analysis revealed significantly higher dp-ucMGP levels in females with preserved to moderately reduced renal function, while no sex-related differences were observed in advanced CKD.
Conclusion: Patients with pre-dialysis CKD demonstrated poor vitamin K2 status, as reflected by elevated dp-ucMGP levels. These findings support growing evidence that vitamin K2 deficiency is common and clinically relevant in the earlytages of CKD.
Keywords: CKD, pre-dialysis patients, dephosphorylated uncarboxylated MGP, dp-ucMGP, vitamin K2,
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Please cite this article as: Simeonova T, Ignatov B, Tolekova A, Eftimova T, Blazhev A, Kostov K. Vitamin K2 Status in Patients with Pre-Dialysis Chronic Kidney Disease. J of IMAB. 2026 Jan-Mar;32(1):6760-6764. [Crossref - 10.5272/jimab.2026321.6760]
Correspondence to: Tatyana Nedkova Simeonova, Department of Physiology and Pathophysiology, Medical University-Pleven; 1, St. Kliment Ohridski Str., Pleven 5800, Bulgaria; E-mail: dr_tsimeonova@abv.bg
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Received: 02 October 2025
Published online: 25 March 2026