Pharmacodynamics of menatetrenone and effects on bone metabolism in continuous ambulatory peritoneal dialysis patients.

Prevention of osteoporosis and renal osteodystrophy are important for the long-term quality of life in dialysis patients. We examined whether administration of menatetrenone (vitamin K2) improves bone metabolism in continuous ambulatory peritoneal dialysis (CAPD) patients. Administration of a single dose of menatetrenone (15 mg) revealed that the 24-h pharmacodynamics in CAPD patients were comparable to those in control individuals. In a 12-month period of oral menatetrenone administration (45 mg/day), eight stable CAPD patients were studied for blood-bone metabolism parameters and for bone mineral content. Blood concentration of menatetrenone was detectable during the experiment period. Only at 12 months did active vitamin D3 and bone-type alkaline phosphatase (ALP) fall significantly, while total ALP rose significantly. Bone mineral density measured by dual-energy X-ray absorptiometry remained at the same level throughout the study period, suggesting that menatetrenone may protect against bone mineral loss in CAPD patients. These results show that the same dose of oral menatetrenone can be given to CAPD patients as to control individuals, and that menatetrenone can be used safely for 1 year in CAPD patients.