about vit K

Question

My child 3 years old has CF form birth. He uses fat soluble vitamins. What about vit K?

Answer

Dear Questioner,
Vitamin K is needed for making clotting factors and therefore important for the coagulation of blood. Recent research revealed, however, that it is also important for the bone mineralisation. Patients with CF are at risk of developing vitamin K deficiency because its absorption from the gut is dependent on bile salt and pancreatic enzyme secretion. There are other risk factors of having a vit K deficiency such as liver disease, frequent antibiotic therapy, inadequate intake and short gut syndrome resulting from bowel resection.
Vitamin K deficiency can be a serious problem due to the lack of prothrombin (one of the clotting factors) and can lead to severe bleedings, especially in patients with severe liver or lung disease.
Furthermore, deficiency can support the development of bone disease in CF.
As direct measurements of serum vitamin K levels are not routinely available, deficinecy can often only indirectly be measured by prolongation of prothrombin time. But as latest research reveald the importance for vitamin K in bone mineralisation, the recommendation of supplementing vitamin K to all patients with Cf is discussed. At the moment, there is not yet sufficient evidence to recommend universal vitamin K supplemetation for bone health in CF, but it should be considered in patients with low bone mineral density, liver disease and/or prolonged prothrombin time.
I hope I could have helped you further with this information.

The latest guidelines on this topic can be read here:

Consensus Report on Nutrition for Pediatric Patients With Cystic Fibrosis by Drucy Borowitz, Robert D. Baker, and Virginia Stallings (Journal of Pediatric Gastroenterology and Nutrition 35:246–259, 2002)

UK CF Trust Report of Bone Mineralisation Working Group February 2007

Sinaasappel et al, 2002. Nutrition in patients with cystic fibrosis: a European Consensus. Journal of Cystic Fibrosis. 2002 Jun;1(2):51-75.


Regards,
Sigitas Dumcius

04.06.2008