Can too much of a water soluble vitamin really be bad for your kidneys? I first ran across an article “B Vitamins Harm Kidneys” in the June issue of Nutrition Action Healthletter (http://www.cspinet.org/). According to the article about a Canadian research study, 238 diabetics with early stage chronic kidney disease (CKD) took a high dose folic acid, vitamin B-6, vitamin B-12 pill or a placebo. After three years the study revealed a greater decrease in kidney function and heart attack or stroke in the participants receiving the B vitamin. Read more…

Vitamin D is a hot topic.  Articles appear almost weekly in newspapers, magazines, journals and online.  I’ve heard several television reports just over the past week.  In a posting back in April, I covered some basics on vitamin D and why it’s important for chronic kidney disease and dialysis patients. Today I’m focusing on the best way to get vitamin D and how it works in the body. Read more…

I’ve been running across lots of information on vitamin D lately. It turns out that many people are deficient in vitamin D. Doctors are starting to check vitamin D levels and prescribe vitamin D3 supplements. Have you had your level checked yet? If you are indoors most of the time or use sunscreen when you go outside, or live in the north you may be at risk for vitamin D deficiency. Low levels have been linked to cancer, diabetes, heart disease and kidney disease. You have a 26 percent greater risk of dying if you are deficient in vitamin D.
There are several sources of vitamin D. Read more…

Multivitamins or standard over-the-counter supplements are not suggested for dialysis patients as a replacement for renal vitamins for several reasons:

• Patients with kidney failure require more folic acid. Multivitamins and standard supplements do not supply enough folic acid to meet the requirements of those with end stage renal disease.
• All supplements that contain vitamin A are avoided in chronic kidney disease because the damaged kidneys are unable to remove it from the body. Excess vitamin A is very toxic.
• Vitamin D in a multivitamin or standard vitamin D supplement cannot be used by the body since the damaged kidney can no longer activate it. Special activated vitamin D formulas are prescribed if needed, along with careful monitoring of calcium, phosphorus and parathyroid hormone (PTH) levels.
• Vitamin C doses above the RDA are not recommended for kidney patients because it increases risk for oxalate deposits and kidney stones. Doubling up on a multivitamin or taking additional vitamin C can easily exceed the goal for dialysis patients.
• Cost may be higher if multiple supplements are purchased to replace renal vitamins. Many prescription plans cover the cost of renal vitamins. Some pharmacies offer generic over-the-counter brands at a lower price.
• Why add more pills than needed? Most kidney patients already take many pills.

Renal vitamins contain B vitamins and a limited dose of vitamin C to help replace losses related to dialysis in those with end stage renal disease. The B vitamins, also called the B-complex, are a combination of eight water soluble vitamins: Read more…

Dialysis patients are instructed to take their renal vitamin once a day. For hemodialysis patients, renal vitamins are taken after dialysis. The reason is that vitamins B and C are water soluble and easily removed from the blood during dialysis if the vitamin is taken before the treatment.

If forgetting to take the renal vitamin is a problem, try to make a habit by taking it at the same time each day.

People on dialysis take a special renal vitamin preparation that contains B vitamins with extra folic acid and a limited amount of vitamin C. There are several reasons why dialysis patients take renal vitamins:

• to replace vitamins removed during each dialysis treatment
• the dialysis diet is inadequate in vitamins due to limits on fruits, vegetables and foods like milk, whole grains, nuts seeds and legumes
• a limited variety of foods and poor appetite contributes to nutrient deficiencies
• adequate amounts of folic acid, vitamin B12, and vitamin B6 are required to make red blood cells and prevent anemia
• vitamin deficiencies increase risk for infection

Examples of renal vitamins are Dialyvite®, Nephrocaps®, Nephrovite®, Nephplex®, and Renaltab®. Some brands require a prescription and others are available over the counter. Kidney doctors or renal dietitians usually make recommendations on which renal vitamin to take.