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 kidney disease often cannot get enough of some vitamins.
Some vitamins must be limited or even avoided because levels build up in the body as the kidneys stop working. Below is an overview of the vitamins your body cannot do without and the dietary recommendations for patients with chronic kidney disease.
|Vitamin A||Promotes the growth of body cells and tissues; helps protect against infection, essential for night vision||Levels are usually elevated; supplementation not recommended, may cause toxic levels; if needed to treat deficiency, limit to the Daily Reference Intake (DRI) 700-900 ug/day|
|Vitamin D||Helps the body absorb calcium and phosphorus; deposits these minerals in bones and teeth; regulates parathyroid hormone (PTH)||In CKD the kidney loses the ability to make vitamin D active. Supplementation with special active vitamin D is determined by calcium, phosphorus and PTH levels and available only by physician prescription; dose must be individualized and monitored closely|
|Vitamin E||Antioxidant; helps protect body cells from oxidation and free radicals to protect against illnesses like heart disease and some types of cancer||Supplement generally not needed; RDI is 8 to 10 milligrams per day.
Very high doses (800 mg) may increase blood clotting time, especially for people on blood thinners.
|Vitamin K||Helps make blood clotting proteins, important for healthy bone formation||Supplements generally not needed unless long term poor intake combined with antibiotic therapy. Supplements can cause increased blood clotting and interfere with blood thinners|
|Vitamin B1 (thiamin)||Helps the body’s cells produce energy from carbohydrates, helps nervous system work properly||1.5 mg/day supplement recommended in addition to daily dietary intake|
|Vitamin B2 (riboflavin)||Helps cells produce energy, supports normal vision and healthy skin||1.8 mg/day supplement for CKD on a low protein diet;
1.1-1.3 mg/day supplement for those on dialysis, especially with poor appetite
|Niacin||Helps the body use sugars and fatty acids; helps body cells produce energy; helps enzymes function in body; can be made from the amino acid tryptophan||14 to 20 mg/day supplement recommended for CKD patients (dialysis and non-dialysis). Excess doses may cause flushing|
|Vitamin B6||Helps the body make protein, which is then used to make cells; also helps make red blood cells; changes tryptophan (an amino acid) into niacin||5 mg/day supplement for CKD non-dialysis 10 mg/day supplement for dialysis.
50 mg/day when prescribed with folic acid and vitamin B12 to reduce homocysteine levels.
Large doses (200 mg/day) over long period can cause nerve damage.
|Folate||Helps make DNA for new body cells; works with vitamin B12 to make red blood cells||1.0 mg/day supplement recommended for CKD (dialysis and non-dialysis).
Include vitamin B12 or check blood levels; folate supplements can mask a vitamin B12 deficiency.
|Vitamin B12||Helps make new body cells; maintains nerve cells; works with folate to make red blood cells||2-3 ug/day supplement recommended for CKD (dialysis and non-dialysis); deficiency can cause permanent nerve damage;
Always include B12 supplement with folate.
|Vitamin C||Helps the body absorb iron; helps manufacture collagen, form and repair red blood cells, bones and other tissues; keeps capillary walls and blood vessels firm; protects against bruising; maintains healthy gums and heals cuts and wounds; keeps immune system healthy||60-100 mg/day supplement recommended for CKD patients (dialysis and non-dialysis).
Excess intake may cause oxalate deposits in bone and soft tissues
|Biotin||Helps body cells produce energy; helps metabolize protein, fat and carbohydrates in food||30-100 ug/day supplement recommended for CKD patients (dialysis and non-dialysis); dietary intake may be inadequate on a low protein diet|
|Pantothenic Acid||Helps body cells produce energy; helps metabolize protein, fat and carbohydrates||5 mg/day supplement recommended for CKD patients (dialysis and non-dialysis)|