Vitamin K's Effectiveness in Coagulopathy Management for Liver Disease

This report discusses coagulopathy, a condition characterized by disrupted hemostasis leading to excessive bleeding or clotting, often linked to liver dysfunction and vitamin K deficiency. The liver's role in synthesizing coagulation factors is highlighted, and the report explores how liver disease can lead to coagulopathy. Vitamin K's importance in coagulation pathways and the consequences of its deficiency, such as hypoprothrombinemia, are examined. While vitamin K is typically used to manage coagulopathy, research studies suggest its limited effectiveness in treating liver cirrhosis-associated coagulopathy, with some studies indicating it does not significantly improve coagulation parameters in patients with liver disease. The report concludes by noting the lack of strong evidence supporting vitamin K's ability to reduce hypoprothrombinemia in liver disease patients.

Running head: COAGULOPATHY
COAGULOPATHY
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1COAGULOPATHY
Coagulopathy has been defined as the homeostasis disruption which results in either
excessive clotting or excessive bleeding (1). The liver has been found to play a major role in
homeostasis which is associated with the synthesis of coagulation factors. Thus, it can be
stated that a failure in the synthesis of both antithrombotic and prothrombotic factors leads to
coagulopathy (2). According to a piece of research study, it can be stated that the extent of
coagulation is dependent on the functionality degree of liver cells (5). Vitamin K deficiency
has been found to be associated with a decreased synthesis of coagulation factors, excess
fibrinolytic activity, and thrombocytopenia (2). Vitamin K is either absorbed externally or
internally by the human body. Vitamin K has a major role to play in the coagulation
pathways where it works as a cofactor of proteins consisting of carboxyglutamic acid
restudies (6). Vitamin K deficiency has been found to lead to abnormalities in the production
of potassium dependent factors such as factor VII, IX, and X including protein C and S (5).
Vitamin K has been found to indicate the prevention of hypoprothrombinemia which is
caused by warfarin derivative. This disorder is also stated to be caused by other vitamin K
deficiency disorders which are drug-induced in their nature. As indicated in patients, with
hypoprothrombinemia, secondary to malabsorption including the inability to synthesize
vitamin K and prophylaxis for the prevention of vitamin K deficiency has been found to be
associated with patients receiving total parental nutrition (TPN) (7). This vitamin has been
found to be administered in dose ranges between 1 to 25 mg/day through intramuscular,
subcutaneous, oral or intravenous routes which depend on the severity and cause of vitamin
K deficiency (8). The action of vitamin K has been found to be six to ten hours after oral and
one to two hours after intravenous administration. The liver has been noted to synthesize bile
acids that are secreted into the small intestine. In this organ, they play a major role in the
absorption of lipophilic compounds. Oral administration of vitamin K has been found to be
associated with the presence of bile salts for their absorption. Management of coagulopathy

2COAGULOPATHY
has been found to be important because of the fact that some procedures progress to
hemorrhage and thrombosis which depends on risk factors. Thus, vitamin K has been used to
manage coagulopathy in end-stage liver disease patients. Rivosecchi et al. have been found to
perform a research study to analyze the effectiveness of vitamin K administration on INR in
patients with liver cirrhosis. They concluded that vitamin K is not efficient in controlling
liver cirrhosis associated coagulopathy. Saja et al. have assessed vitamin K administration
efficiency in a series of coagulation parameters in the four stages of liver diseases among
patients. They concluded that vitamin K did not cause any significant improvement in the
patients. Thus, it can be stated that there is a lack of evidence for the fact that vitamin K
reduces hypoprothrombinemia in liver disease patients.