According to the Institute of Medicine, the human body needs at least 13 vitamins to function properly. Following a balanced diet is the preferred way to get the recommended amount of these vitamins. People with chronic kidney disease (CKD) often cannot get enough of some vitamins due to:
- Necessary dietary restrictions
- Poor appetite
- Disruptions in meal times due to treatments and appointments
- Medication side effects
- Vitamin losses during the dialysis treatment
That being said, a lot of vitamins available in the market are not made with kidney patients in mind. These vitamins can have higher level of unwanted content (vitamins, minerals, metal) which can be harmful, especially if the kidney is not filtering at its best. It is very important to focus on kidney-specific vitamins as prescribed by your nephrologist.
Which vitamins do I need if I am a CKD patient?
Vitamins fall into two classes: fat soluble and water soluble. Water soluble vitamins do not build up in the body and must be replaced daily from the diet. CKD patients have greater requirements for some water soluble vitamins. Special renal vitamins are usually prescribed to kidney patients to provide the extra water soluble vitamins needed. Renal vitamins contain B1, B2, B6, B12, folic acid, niacin, pantothenic acid, biotin and a small dose of vitamin C.
What vitamins should a CKD patient avoid?
The fat soluble vitamins (A, D, E and K) are more likely to build up in your body, so these are avoided unless prescribed by your kidney doctor. Vitamin A is especially a concern, as toxic levels may occur with daily supplements.
Your nephrologist will decide if a vitamin D supplement is needed based on blood tests that measure calcium, phosphorus and parathyroid hormone (PTH) levels. As CKD progresses, the kidney’s ability to activate vitamin D is lost. A special activated vitamin D may be prescribed along with blood work to monitor calcium and PTH levels.
Vitamin C in kidney patients can cause a buildup of oxalate, which can be deposited in the bones and soft tissues.
How do I determine which vitamins, if any, to take?
If your doctor has not prescribed a vitamin supplement, ask if you could benefit from taking one. Only use the vitamin supplement approved by your nephrologist. Supplements such as popular multivitamins and super-strength vitamin products may contain vitamins or minerals that should be limited or avoided by CKD patients.