Water‐soluble vitamin levels in extended hours hemodialysis

Abstract

Patients on extended hours (>15 h/week) hemodialysis may be at a higher risk of deficiency of water-soluble vitamins than conventional (≤15 h/week) hemodialysis patients due to their increased weekly hours of dialysis. We compared serum levels of the water-soluble vitamins in a group of extended and conventional hours hemodialysis patients. Predialysis serum levels of vitamin C, vitamin B12, thiamine, pyridoxine, and folate were measured in 52 patients: 26 extended group and 26 conventional group. Information on patient's intake of vitamin supplements and dialysis regimen was obtained. Data were log transformed due to the skewed distribution of the results. Median vitamin C levels were significantly lower in the extended group (0.30 vs. 1.14 mg/dL, P<0.001), with 7 patients having a level <0.18 mg/dL. Thiamine levels were also lower in the extended group (median 211 vs. 438.5 nmol/L, P=0.0005). However, extended patients had higher levels of pyridoxine (23.2 vs. 11.1 ng/mL, P=0.03). Vitamin B12 and folate levels were not significantly different between the groups. There was significant variability in vitamin supplement prescription in both groups, and dietary data were not obtained. This study showed a high incidence of vitamin C deficiency in extended hours hemodialysis patients, suggesting that supplementation is warranted. It also supports an ongoing role for multivitamin supplementation in conventional hemodialysis patients.

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

“…Consistent to the findings of previous reports, we have not identified significant thiamine deficiency in pre-dialysis measurements as compared to reference values for healthy humans [14,15,17,20,21]. However, in view of high concentrations of oxythiamine, an antythiamine compound, reported recently in ESRD by Zhang et al [5], the reference concentrations of thiamine might not necessarily comply with its increased needs in hemodialysed patients.…”

Is vitamin B6 deficiency an under-recognised risk in patients receiving haemodialysis? A systematic review: 2000-2010

“…Routine supplementation of PLP in addition to standard vitamin B and folate was recommended for this group. In another study that was published following this systematic review, extended dialysis patients had a higher level of PLP compared with the conventional group 27 . The extended hours group, however, all received supplementation while the conventional group did not.…”

Vitamins and Microelement Bioavailability in Different Stages of Chronic Kidney Disease

“…The vitamin deficiency was not observed in patients receiving 50 mg pyridoxine after each dialysis session [35]. Conversely, in those CKD patients not receiving B6 supplementations, the B6 deficiency was found in 78%, 77%, 50%, and 34% of cases, respectively [36,37,38,39]. …”