Vitamin A: Patients with renal failure have high levels of vitamin A in their blood. Generally, supplementing a small amount of vitamin A may cause poisoning, so it is not appropriate to take extra vitamin A. Hemodialysis has little effect on the level of vitamin A in blood of patients with chronic renal failure. In patients with good renal function after renal transplantation, the plasma vitamin A will gradually decrease.
Vitamin d: the ability of kidney to synthesize vitamin d decreases with the decline of renal function. Calcium carbonate or vitamin D supplementation can correct the disorder of calcium and phosphorus metabolism.
Vitamin E: For patients with chronic renal function and maintenance hemodialysis, it is generally not necessary to supplement vitamin E. Even a low-protein diet can provide enough vitamin E, and vitamin E will not be lost through hemodialysis.
Vitamin K: The kidney has little influence on the metabolism of vitamin K. In the case of nephropathy or chronic renal failure, vitamin K may have some influence on the metabolism of kidneys and bones. Patients with chronic renal failure do not need routine vitamin K supplementation. Patients with chronic renal failure treated with antibiotics should monitor prothrombin time, protein S and protein C levels and supplement vitamin K when necessary. When vitamin K deficiency occurs in patients with renal diseases, urinary calcium excretion and bone calcium loss increase, which may cause renal osteopathy and increase the incidence of fractures.
(2) Water-soluble vitamins:
Vitamin C: The incidence of vitamin C deficiency in maintenance hemodialysis or peritoneal dialysis patients is high, but if a large amount of vitamin C is supplemented, oxaloacetate deposition in plasma and soft tissues may increase, causing hyperoxalemia. For patients with chronic renal failure, maintenance hemodialysis or peritoneal dialysis, the recommended dose of vitamin C supplement is 60 mg per day.
Vitamin B 1: High permeability dialysis membrane can increase the loss of vitamin B 1, so vitamin B 1 deficiency is not uncommon in maintenance hemodialysis patients. Because the symptoms of vitamin B 1 deficiency are not obvious, it is easy to be missed. Patients on maintenance hemodialysis and peritoneal dialysis should be supplemented with vitamin B 1 daily, in addition to 0.5 ~ 1.5 mg in food, they should also be supplemented with 1 ~ 5 mg.
Vitamin B2: Patients with low protein diet, maintenance hemodialysis and peritoneal dialysis may have a small amount of vitamin B2 deficiency, but most patients can get supplements from their diet. To prevent vitamin B2 deficiency, it is recommended to supplement 1.2 ~ 2.0 mg daily.
Vitamin B6: No matter receiving conservative treatment, hemodialysis or peritoneal dialysis, vitamin B6 deficiency can cause amino acid metabolism disorder, and cause or aggravate some clinical manifestations of late renal failure, such as peripheral neuropathy, primary anemia, low immune function, susceptibility to infection and dysfunction of central nervous system. Maintenance dialysis patients and patients with nephropathy need vitamin B6 supplement, which is generally considered as 10 ~ 50mg per day.
Vitamin B 12: Patients with chronic renal insufficiency and maintenance dialysis patients are deficient in vitamin B 12, but the daily intake of vitamin B 12 should not be lower than 1 mg.
Folic acid: Folic acid deficiency is very common, because chronic renal failure patients without dialysis and dialysis tend to retain toxins in the body. Folic acid should be properly supplemented for kidney diseases, and it is recommended to take 5 ~ 10 mg every day.
Nicotinic acid: The low-protein diet of renal failure patients provides less nicotinic acid, and a small amount of nicotinic acid is also lost in the dialysate of maintenance dialysis patients. It is suggested that patients should take niacin 13 ~ 19 mg daily.
Biotin: The low-protein diet of patients with chronic renal failure provides less biotin and its absorption is reduced. It is suggested that patients with chronic renal failure should be supplemented with 30 ~ 100 micrograms of biotin every day.