Vitamin B6-Mangel und -Substitution bei chronischer Ur�mie

Abstract

In patients with chronic renal failure on potatoe-egg-diet (0.4 g protein/kg body weight) an alimentary vitamin B6-deficiency occurs, which can be overcome by 20 mg vitamin B6/day. Chronic hemodialysis causes a vitamin B6 loss which amounts to a quantity similar to the daily urinary excretion in normal persons. No hints for an inhibition of the synthesis of pyridoxal phosphate could be found.

Nutrition in Acute Renal Failure

“…Generally, there is a defi ciency of the former due to low intake, al tered metabolism or losses during dialysis treatment [39], including ascorbic acid losses of 280 mg [54] and folic acid of 0.15 g [45] during one hemodialysis treatment. Supple mentation of pyridoxine hydrochloride is also necessary in order to prevent vitamin B6 deficiency which has been demonstrated in patients undergoing maintainance hemodial ysis [24], In reference to fat-soluble vita mins, vitamin A supplementation should be avoided. Serum vitamin A levels are ele vated in chronic uremia and vitamin A sup plementation may cause hypervitaminoses in chronically uremic patients [17], There is a requirement for vitamin D and K supple mentation in ARF because the turnover of 1,25-dihydroxycholecalciferol is accelerated in acute uremia and vitamin K. deficiency arises when patients do not eat and/or re ceive antibiotics [60], The vitamin supple mentations advised in TPN in ARF are shown in table I.…”