Thiamine Diphosphate Status and Dialysis-Related Losses in End-Stage Kidney Disease Patients Treated with Hemodialysis

Abstract

Aim: (1) To describe the whole blood content of thiamine diphosphate (TDP), a biologically active form of vitamin B1 in end-stage kidney disease patients treated with hemodialysis (HD); (2) to establish the impact of a single HD procedure on TDP blood concentrations; and (3) to describe potential explanatory variables influencing TDP dialysis related losses, including dialysis prescription, vitamin B1 dietary intake and supplementation. Methods: Single-center, cross-sectional study in 50 clinically stable maintenance HD patients. The assessment of whole blood TDP with the High Performance Liquid Chromatography method, before and after a single, middle-week dialysis session and analysis of clinical and laboratory parameters potentially influencing TDP status Results: We report a significant difference in TDP levels before and after HD sessions - 42.5 (95% CI 38.7-46.2) μg/L and 23.6 (95% CI 18.9-28.2) μg/L, respectively (p = 0.000). The magnitude of intradialytic TDP changes is highly variable among individuals and is negatively associated only with the body weight of the patients (p < 0.013). Vitamin B1 dietary intake and supplementation do not influence whole blood TDP and dialysis-related loss of TDP. Conclusions: TDP, a bioactive compound of vitamin B1, is substantially lost during the HD procedure, and the magnitude of its loss is associated with the patient's body weight but it is not influenced by vitamin B1 dietary intake and standard supplementation dose.

Water-Soluble Vitamins and Trace Elements Losses during On-Line Hemodiafiltration

“…There are conflicting data available on the loss of thiamine during HD, as different dosing methods were used [ 2 , 18 , 19 ]. Moreover, low thiamine pyrophosphate blood level in MHD patients is infrequent at the beginning of the session [ 20 , 21 ], a finding that is confirmed in the present study, probably in response to the western diet and the absence of loss into the dialysate. However, because of the functional thiamin deficiency in plasma that is well described in end–stage renal disease [ 2 , 22 ], dietary vitamin intake must be evaluated and supplemented if necessary.…”

Water-Soluble Vitamins Status in Patients Undergoing Maintenance Hemodialysis

“…Jankowska et al measured that thiamine diphosphate (TDP), a bioactive compound of vitamin B 1 , is substantially lost during the HD procedure, and the amount of its loss is associated with body weight. It is not influenced by vitamin B 1 dietary intake and standard supplementation dose [ 27 ].…”

Delirium in Critical Illness Patients and the Potential Role of Thiamine Therapy in Prevention and Treatment: Findings from a Scoping Review with Implications for Evidence-Based Practice

“…Proton pump inhibitors (PPIs) reduce thiamine absorption, furosemide causes increased thiamine excretion. Decreased thiamine levels have also been reported in patients undergoing dialysis therapy [7,[32][33][34].…”

“…Proton pump inhibitors (PPIs) reduce thiamine absorption, furosemide causes increased thiamine excretion. Decreased thiamine levels have also been reported in patients undergoing dialysis therapy [7,[32][33][34]. Conditions in which metabolic processes are activated and require increased metabolic demands associated with infection increase the risk of thiamine deficiency.…”