Vitamin K1 and K2 in the Diet of Patients in the Long Term after Kidney Transplantation.

Vitamin K, especially its K2 form, is considered to be a protective factor against developing vascular changes and bone lesions that are common complications in kidney transplant (KTx) recipients. There is a growing number of studies showing that KTx patients are at risk of vitamin K deficiency. The aim of this study was to evaluate the intake of vitamin K1 and K2 in the diet of patients in the late period after KTx. During a routine visit at one outpatient transplantation clinic in Central Europe, a diet survey questionnaire was filled in by 151 clinically stable KTx recipients and compared with medical history, anthropometric measurements and laboratory tests. Mean vitamin K1 intake was 120.9 ± 49 µg/day and vitamin K2 (MK, menaquinone) intake 28.69 ± 11.36 µg/day, including: MK-4: 25.9 ± 9.9 µg/day; MK-5: 0.1 ± 0.2 µg/day; MK-6: 0.2 ± 0.4 µg/day; MK-7: 0.2 ± 0.23 µg/day; MK-8: 1 ± 1.9 µg/day; MK-9: 0.9 ± 2.3 µg/day; and MK-10: 0.2 ± 0.5 µg/day. Our study showed that KTx recipients' diets contained adequate amounts of vitamin K1, whereas the intake of vitamin K2 seemed insufficient.

The role of disaccharidases in the digestion - diagnosis and significance of their deficiency in children and adults.

Disaccharidases are a group of enzymes of the small intestinal brush border, that are essential for degradation of disaccharides (sucrose, lactose, maltose, isomaltose, trehalose) into monosaccharides, which are then absorbed from the gastrointestinal tract. Their deficiency may occur at any stage of human life and have a genetic basis or be a secondary to ongoing gastrointestinal disease. Disaccharidase deficiencies cause disorders of digestion and absorption leading to occurrence of clinical symptoms such as abdominal pain, flatulence, diarrhea. For more than fifty years disaccharidase activity (DA) measurements in the small intestine biopsy samples are still considered the "gold standard" in the diagnostics for disaccharide deficiency. The aim of this review was to emphasize the role of disaccharidases in the digestion. Moreover, the significance of their deficiency in children and adults based on the current knowledge was described. It was showed that deficiency or inactivity of disaccharidases may lead to gastrointestinal intolerance symptoms. Early diagnostics allows the initiation of appropriate treatment, which contribute to reduction or complete resolution of clinical symptoms.

Nutrition Trends in Patients Over the Long Term After Kidney Transplantation.

OBJECTIVES: Nutritional behaviors may exert important influence on morbidity and graft function in patients after kidney transplantation (KT). Nutritional status is closely related to potential risk factors of developing posttransplant complications, including diabetes mellitus, weight gain, and negative effects on immunosuppressive therapy. The aim of this study was to assess the dietary intake in patients after KT. DESIGN AND METHODS: Nutritional intake of 154 (61 women and 93 men) patients was assessed based on a questionnaire regarding food intake (proteins, fats, carbohydrates, cholesterol, sugar, phosphorus, calorific value) within 3 working days preceding the routine outpatient posttransplant visit. Patient medical history, concomitant medications, and estimated glomerular filtration rate (eGFR) was obtained from medical charts. RESULTS: The mean age (years) ± SD of patients was 51.9 ± 14.1. The patients were evaluated 94 ± 67 months after KT, with a median eGFR of 53 (range, 41.2-64.1) mL/min/1.73 m2. Sixty-two percent of patients had increased body mass index values. The mean total energy intake was 2159.4 ± 551.9 kcal/day. The patients reported elevated salt (8.5 ± 2.4 g per day) and fat intake (99.4 ± 3.2 g per day) including 57% saturated fatty acids. The patients consumed products containing high amounts of sugars (108.2 ± 107.0 g per day), carbohydrates (238.3 ± 64.3 g per day), and cholesterol (303.6 ± 11.1 mg per day). The diet among kidney recipients consisted predominantly of fats, meat, cured meat, and sweets. CONCLUSIONS: The nutritional behaviors of patients after KT are in most cases poor. Improvement of eating habits in these patients seems to be a simple method to preserve kidney function over the long term.

[The importance of diet in the prevention of adverse reactions to vitamin K-dependent anticoagulants]. / The importance of diet in the prevention of adverse reactions to vitamin K-dependent anticoagulants.

Due to the increasing number of patients suffering from cardiovascular diseases, the number of patients started on anticoagulants is also rising. Diet is a modifiable factor of effective treatment. It is of particular importance due to the strong correlation of anticoagulants with vitamin K, other diet components and drug-food interactions in long-term treatment. Chronic treatment with anticoagulants may precipitate a number of adverse reactions, and following an appropriate diet may minimise the side effects of drugs that alter blood coagulation. There is a relationship between diet rich in vitamin K and oral VKAs. Maintaining a constant concentration of vitamin K in everyday diet allows to decrease complications resulting from chronic intake of hydroxycoumarin derivatives. Nutritional education of patients on longterm treatment with VKAs may help to decrease adverse reactions. Collaboration between the patient and the dietician and between the dietician and the doctor may positively affect the maintenance of a stable diet necessary in patients undergoing long-term anticoagulant treatment.