Vitamin K naturally occurs as type 1, which predominantly activates hepatic, i.e. coagulation-relevant vitamin K-dependent proteins (VKDPs), and type 2, activating the extra-hepatic VKDPs, including the Matrix gla protein (MGP) and osteocalcin. The latter VKDPs seem to be involved in the prevention of ectopic mineralization, thus contributing to cardiovascular disease prevention. Patients with chronic kidney disease (CKD) commonly experience sub-clinical vitamin K deficiency, characterized by low levels of circulating vitamin K and high levels of inactive VKDPs, which is further aggravated by the use of vitamin K antagonists (VKA). The latest NDT Digest article reports on the promising protective and therapeutic potential of vitamin K supplementation in CKD patients.