Micronutrition in Dialysis

Abstract

A variety of dialysis methods are currently used in the treatment of renal failure. Nutrition support modalities are also frequently used for patients with renal failure who are malnourished or at risk of becoming malnourished. The effects of various dialysis methods on certain micronutrient levels and needs have generally not been extensively studied, however, this article reviews information that has been published regarding carnitine, water soluble vitamin, fat soluble vitamin, and trace element levels during dialysis. Recommendations for provision of micronutrients during dialysis are provided.

Dietary Micronutrient Intake in Peritoneal Dialysis Patients: Relationship with Nutrition and Inflammation Status

“…In chronic kidney disease patients, niacin has the potential for lipid-lowering and anti-inflammatory effects, and it may be a promising phosphate binder (27,28). Niacin deficiency has been not much studied in renal failure and CAPD; however, it may, like other water-soluble vitamins, be lost through dialysate (29). Thus, niacin supplementation according to the DRI seems to be a prudent recommendation.…”

Serum concentrations and clearances of folic acid and pyridoxal-5′-phosphate during venovenous continuous renal replacement therapy

“…On the other hand, it is known that hydrosoluble vitamins (vitamin C and B-complex vitamins) can be dialyzed to some extent, especially during high-flux intermittent hemodialysis [4,5]. The three vitamins for which chronic dialysis patients are most at risk for deficiency are vitamin C, folic acid, and vitamin B6 [6].…”

Lipophilic Antioxidants and Iron Status in ESRD Patients on Hemodialysis

“…A disturbance in plasma vitamin levels occurs frequently in hemodialysis patients. Inadequate dietary intake resulting from uremia-associated anorexia and dietary restrictions, metabolic derangement associated with renal failure and losses into the dialysate are among the contributory factors [30, 31, 32]. In some previous studies, blood concentrations of the lipophilic antioxidants have been reported to be low in predialysis [14, 20]and hemodialysis [20, 21]patients.…”