Vitamins for Kidney Disease.
These days many people take multivitamins for a variety of reasons. Some people take multivitamins because they want to remain healthy, others want to prevent disease and yet others simply want to ensure that their body gets the essential minerals and vitamins which they may lack in a diet. Over the past few decades, the dietary habits of Americans have changed; many eat few veggies and fruits and consume vast quantities of processed or fast foods. These changes in dietary habits can lead to various mineral and vitamin deficiencies, especially in people who are ill, young, and very old. But the problem is even worse in individuals on dialysis and those with chronic kidney issues. For example, some vitamins may not be well absorbed by the gut and others may be lost during the dialysis procedure. There is no question that taking certain vitamins for kidney issues and mineral supplements is the best way to prevent nutritional deficiencies that may occur as a result of a poor diet. But it is also important to understand that one should always make an attempt to eat a healthy diet at the same time.
Who should take multivitamins?
- Those who have a poor appetite and/or consume less than 1,500 calories per day. Many individuals with kidney problems fall into this group.
- Vegetarians and vegans who have a very restricted diet
- Individuals who do not consume at least 2-3 servings of fresh fish every week. If the person lives in an area where fresh fish is not readily available, then experts recommend adding a supplement containing fish oil to the daily dietary regimen.
- Any female who experiences menstrual periods with heavy bleeding
- Individuals who have a medical disorder that prevents the body from absorbing the essential minerals and nutrients from the intestine like food allergies, food intolerance, chronic diarrhea, inflammatory bowel disease, malabsorption, gallbladder, and pancreatic disorders.
- Individuals who have had surgery on the intestine or have had the intestines removed making it impossible for nutrients to be absorbed into the body
- Individuals on dialysis and chronic kidney problems who have a decreased appetite
Poor diet and kidney function
Over the past few decades, many studies have shown that as malnutrition progresses so does the decline in kidney function. Some of the things that have been observed in individuals with kidney issues and poor nutrition include the following:
- As the kidney function continues to worsen, the individual will usually consume less food- meaning he or she will take in fewer calories and protein
- The kidney itself also affects the way the body handles the absorption and digestion of minerals and vitamins. For some unknown reason, kidney problems also affect the absorption and digestion of certain vitamins.
- As the kidney malfunction progresses, the concentration of most vitamins in the body start to change. Levels of most vitamins start to decrease and others do not even get absorbed into the body.
- Many of the prescription and non-prescription medications that kidney patients consume may prevent or block the normal absorption of minerals and vitamins from the intestine.
Benefits of water-soluble vitamins
Water-soluble vitamins are those vitamins that dissolve in water. This includes Vitamin C and B complex which includes B1 (thiamine), B2 (riboflavin), B6 (pyridoxine), niacin (nicotinic acid), B12, biotin, folic acid, and pantothenic acid. The important thing to know is that Vitamins B and C are not stored in the body and need to be replaced regularly. This can be either via a diet rich in vitamins or taking supplements. Both vitamin C and B are absorbed from the intestine, enter the blood circulation, and are transported to the different organs. Both vitamins B and C are excreted in the urine. In individuals on dialysis, these vitamins are also removed at the same time as other waste products.
- There are many benefits of water-soluble vitamins. Besides providing energy to the body, they are important for healthy skin, good vision, the formation of red blood cells, and a healthy nervous system.
- When there is a deficiency of vitamin B, it can lead to disorders like pellagra, beriberi, and pernicious anemia. Besides people with kidney issues who have no appetite, others who can develop vitamin B deficiency include alcoholics and those who do not eat adequate fruits and vegetables.
- Similarly, vitamin C is also essential for the body, Also known as ascorbic acid, vitamin C is vital for normal wound healing, growth of bones, the formation of teeth, and strengthening of blood vessels. Vitamin C is also critical for the normal functioning of the immune system and absorption of iron from the stomach. If there is a deficiency of vitamin C, it can lead to a disorder called scurvy.
- Humans cannot make vitamins B or C and the storage capacity for both these water-soluble vitamins is limited. Thus, regular intake is recommended. For those who are ill, have a chronic problem like kidney issues, are under extreme stress, smoke, drink alcohol, using many medications, or have a wound, it is highly recommended that they consume vitamin supplements.
- Besides the regular benefits of vitamins B and C, large doses can help ease or prevent the symptoms of a cold, and even lower the risk of certain cancers, cataracts, and heart disease. More recent evidence indicates that multivitamins may even slow down the progression of Alzheimer disease.
- Both vitamins B and C circulate freely in the blood and during dialysis are readily removed. Therefore if the individual does not regularly take supplements of vitamin B and C, he or she will develop a deficiency.
What happens if individuals with kidney issues have low levels of vitamins?
When individuals with chronic kidney problems or dialysis have low levels of vitamins, the following have been reported in several studies:
- When an individual with dialysis has the ‘lost’ water-soluble vitamins replaced, the lifespan is increased
- In some individuals with chronic kidney problems, studies show that not only is vitamin B necessary but the amounts needed for the normal function of the body has to be higher
- Low levels of vitamin B (esp thiamine) have been linked to heart failure, which is a common cause of death in many individuals with chronic kidney issues
Why do people with kidney issues develop vitamin and mineral deficiencies?
- The build-up of the waste products in the body leads to a poor appetite.
- Often individuals with kidney problems have dietary restrictions. Because of restrictions in fluid, they cannot drink many types of juices that are fortified with vitamins.
- Individuals with chronic kidney troubles and dialysis have frequent disruptions in their mealtimes because of numerous appointments, treatments, and procedures. The daily mealtime schedule is completely disrupted and the individual will eat haphazardly.
- Individuals with chronic kidney problems and dialysis are often on numerous medications, which may affect appetite and alter the taste of food
- There is a loss of mineral and vitamins during dialysis
Minerals of importance
Besides the vitamins, individuals with chronic kidney problems also need copper, zinc, and selenium for the following reasons:
- Studies show that individuals on dialysis have low levels of many minerals
- Copper, zinc, and selenium are critical for the function of many antioxidant enzymes that are needed to maintain a healthy immune system and wound healing
- The levels of these minerals start to drop at a very early phase in the kidney problems
- The only way to prevent deficiency of these minerals is to take supplements regularly.
The importance of vitamin D in individuals with kidney troubles cannot be overemphasized and include the following facts:
- The majority of individuals with chronic kidney problems and those on dialysis tend to have low levels of vitamin D
- Even individuals with mild kidney issues have been shown to lose function of the kidney more rapidly when the levels of vitamin D are on the low side.
- Individuals with progressive kidney damage also tend to lose function rapidly and also have a higher risk d death when the vitamin D levels are low
- Overall, there is a link between poor outcomes in people with kidney troubles and low levels of vitamin D
- Individuals with chronic kidney problems can safely consume daily doses of 800-1000 IU of vitamin D
- The levels of vitamin D in individuals with kidney troubles need to be closely monitored
What are current guidelines for individuals with chronic kidney problems and vitamins?
- The National Kidney Foundation states that the individual with chronic kidney issues and on dialysis will develop vitamin and mineral deficiency if they do not take supplements
- The American Dietetic Association recommends that individuals who show a decline in kidney function or have chronic kidney troubles should be prescribed a multivitamin preparation
- Healthcare providers should regularly check the levels of vitamin D in an individual with chronic kidney problems and on dialysis
Because individuals with chronic kidney troubles and those on dialysis are at risk for developing vitamin and mineral deficiencies, the healthcare provider should make a referral to a dietitian. The dietitian should not only recommend foods that should be consumed but develop a menu plan for these individuals. Besides, the dietitian should help these individuals select the right multivitamin supplement. Finally, the dietitian should maintain long-term follow-up to ensure that these individuals are not developing any type of nutritional deficiency.
How do I know which mineral and vitamin I need?
If you have chronic kidney issues or are on dialysis, it is important to have your healthcare provider regularly monitor the levels of these substances. A simple blood test will reveal if you have low levels of vitamins and minerals in the body.
Diet and CKD
It is important that when you have chronic kidney problems that you do not neglect your diet. To ensure that you continue to get an adequate source of vitamins and minerals you should eat the following foods regularly:
- Copper Nut, seafood, seeds, cereals
- Folic acid Dark leafy veggies, whole grains, and fortified cereals
- Magnesium Green leafy veggies, nuts, dairy, whole wheat and soybeans
- Manganese Nuts, legumes, beans, and whole grains
- Selenium Meat, seafood, dairy, and nuts
- Vitamin A Carrots, sweet potatoes, fortified cereals
- Vitamin B1 Whole grains, fortified bread, and cereals
- Vitamin B2 Fortified cereals, bread, and milk
- Vitamin B3 Meat, fish, poultry, whole grains, fortified cereals
- Vitamin B5 Beef, chicken, oats, potatoes, tomatoes, cereals
- Vitamin B6 Fortified cereal and soy products, potatoes and chickpeas
- Vitamin B7 Fruits, liver, and meat
- Vitamin B12 Poultry, meat, dairy, and fortified cereals
- Vitamin C Green veggies citrus fruits, berries, tomatoes, and broccoli
- Vitamin D Fish oil, fatty fish, fortified cereal, and dairy
- Zinc Meat, liver, fortified cereals, and seafood
What doses of vitamins and minerals should I take every day?
- Biotin 30 micrograms
- Folate 400 micrograms
- Vitamin A 600 micrograms
- Vitamin B1 (thiamine) 1.4 mg
- Vitamin B2 (riboflavin) 1.6 mg
- Vitamin B3 (Niacin) 18 mg
- Vitamin B5 (pathothenic acid) 6 mg
- Vitamin B6 (pyridoxine) 2 mg
- Vitamin B12 6 micrograms
- Vitamin C (ascorbic acid) 75 mg
- Vitamin D 5 micrograms
- Calcium 1,000 mg
- Copper 2 mg
- Magnesium 350 mg
- Manganese 5 mg
- Selenium 35 micrograms
- Zinc 15 mg
Today there are many formulations of vitamins and minerals available on the market. Rather than buy each vitamin separately, one should buy a multivitamin complex that contains most of the vitamins and minerals you need. Finally, always buy your vitamin supplements from a reputable dealer to avoid fake and counterfeit products. For more of the latest, check out our YouTube!