Vitamin and mineral management for dialysis patients is a required treatment for people undergoing

dialysis Dialysis may refer to: *Dialysis (chemistry), a process of separating molecules in solution **Electrodialysis, used to transport salt ions from one solution to another through an ion-exchange membrane under the influence of an applied electric pote ...

because during end-stage kidney disease and dialysis the

kidney The kidneys are two reddish-brown bean-shaped organs found in vertebrates. They are located on the left and right in the retroperitoneal space, and in adult humans are about in length. They receive blood from the paired renal arteries; blood ...

s are functioning at less than 15% of normal levels. As a consequence, certain vitamin and mineral restrictions and supplementations are needed.

The kidney’s role in vitamin and mineral metabolism

People on dialysis must follow dietary restrictions, making it difficult for them to get the necessary amounts of certain vitamins and minerals to stay healthy. In addition, vitamins and minerals are lost during the process of dialysis. Therefore, dialysis patients are at risk for vitamin and mineral deficiencies. Since vitamins are necessary for proper metabolism, protein building, and growth it is important for the health of dialysis patients that they are supplemented with any vitamins or minerals that they may be deficient in.Vitamins. The Nephron Information Center. 2013. Accessed 17 July 2014. < http://nephron.org/nephsites/adp/vits.htm>

Nutrients to avoid in dialysis

There are some nutrients that are restricted in kidney failure patients because of the body's inability to excrete excessive amounts of them due to the kidneys not functioning properly. In general, these nutrients include: *

Potassium Potassium is the chemical element with the symbol K (from Neo-Latin ''kalium'') and atomic number19. Potassium is a silvery-white metal that is soft enough to be cut with a knife with little force. Potassium metal reacts rapidly with atmosphe ...

: The kidneys help to regulate potassium levels. When the kidneys are damaged, potassium levels can become elevated. Elevated potassium levels can cause the heart to beat irregularly or even stop. *

Phosphorus Phosphorus is a chemical element with the symbol P and atomic number 15. Elemental phosphorus exists in two major forms, white phosphorus and red phosphorus, but because it is highly reactive, phosphorus is never found as a free element on Ear ...

: The kidneys also help to regulate phosphorus levels in the body. When the kidneys are damaged, they aren't able to remove excessive phosphorus, causing it to build up in blood. Doctors may prescribe a phosphate binder that is taken with meals to help remove excess phosphorus *

Sodium Sodium is a chemical element with the symbol Na (from Latin ''natrium'') and atomic number 11. It is a soft, silvery-white, highly reactive metal. Sodium is an alkali metal, being in group 1 of the periodic table. Its only stable iso ...

: In patients with kidney failure, sodium can cause excessive fluid retention, which can lead to elevated blood pressure, edema, heart failure, and shortness of breath. *

Fluid In physics, a fluid is a liquid, gas, or other material that continuously deforms (''flows'') under an applied shear stress, or external force. They have zero shear modulus, or, in simpler terms, are substances which cannot resist any shear ...

: As kidney damage worsens so does the ability to excrete fluid. In kidney failure patients, excessive fluid intake can result in the same conditions that excessive sodium intake does.

Vitamins and minerals to supplement in dialysis

Many foods that contain phosphorus and potassium (restricted in dialysis patients) also contain

folate Folate, also known as vitamin B9 and folacin, is one of the B vitamins. Manufactured folic acid, which is converted into folate by the body, is used as a dietary supplement and in food fortification as it is more stable during processing and ...

niacin Niacin, also known as nicotinic acid, is an organic compound and a form of vitamin B3, an essential human nutrient. It can be manufactured by plants and animals from the amino acid tryptophan. Niacin is obtained in the diet from a variet ...

riboflavin Riboflavin, also known as vitamin B2, is a vitamin found in food and sold as a dietary supplement. It is essential to the formation of two major coenzymes, flavin mononucleotide and flavin adenine dinucleotide. These coenzymes are involved in ...

, and

vitamin B6 Vitamin B6 is one of the B vitamins, and thus an essential nutrient. The term refers to a group of six chemically similar compounds, i.e., "vitamers", which can be interconverted in biological systems. Its active form, pyridoxal 5′-phosphat ...

(water-soluble vitamins).Mahan, K, Escott-Stump, S, and Raymond, J Krause’s Food and the Nutrition Care Process. 13th ed. St. Louis, MO; Saunders: (2012) Therefore, restricting foods that contain phosphorus and potassium can lead to deficiencies in other important vitamins. In general, the following vitamins and minerals are supplemented in dialysis patients: *

B vitamins B vitamins are a class of water-soluble vitamins that play important roles in cell metabolism and synthesis of red blood cells. Though these vitamins share similar names (B1, B2, B3, etc.), they are chemically distinct compounds that often coexist ...

- Water-soluble vitamins that play a role in red blood cell development to prevent anemia and contribute to metabolism to help change the foods you eat into energy. *

Vitamin C Vitamin C (also known as ascorbic acid and ascorbate) is a water-soluble vitamin found in citrus and other fruits and vegetables, also sold as a dietary supplement and as a topical 'serum' ingredient to treat melasma (dark pigment spots) an ...

- Water-soluble vitamin that aids in keeping tissues healthy, wound healing, and infection prevention. *

Vitamin D Vitamin D is a group of fat-soluble secosteroids responsible for increasing intestinal absorption of calcium, magnesium, and phosphate, and many other biological effects. In humans, the most important compounds in this group are vitamin D3 (c ...

- Normally, the kidney changes vitamin D into its active form, vitamin D3, which helps with calcium absorption. Many dialysis patients have low intakes of calcium due to avoidance of foods containing phosphorus and potassium. Lack of calcium can lead to renal osteodystrophy (bone weakening). On the other hand, too much calcium can cause calcification or calciphylaxis (calcium deposits in places such as the heart. Vitamin D is a fat-soluble vitamin, meaning that excessive amounts can be damaging so it should be prescribed and monitored by a doctor. *

Iron Iron () is a chemical element with symbol Fe (from la, ferrum) and atomic number 26. It is a metal that belongs to the first transition series and group 8 of the periodic table. It is, by mass, the most common element on Earth, right in f ...

- Kidney damage results in inability of the kidney to produce

erythropoietin Erythropoietin (; EPO), also known as erythropoetin, haematopoietin, or haemopoietin, is a glycoprotein cytokine secreted mainly by the kidneys in response to cellular hypoxia; it stimulates red blood cell production (erythropoiesis) in the bo ...

, which stimulates red blood cell production.

References

{{reflist

External links

National Kidney Foundation

Orthomolecular medicine

The kidney’s role in vitamin and mineral metabolism

Nutrients to avoid in dialysis

Vitamins and minerals to supplement in dialysis

See also

References

External links