Taking vitamins supports different bodily functions. Vitamins and minerals help heal wounds and boost the immune system, among others. The Institute of Medicine shared that the human body needs at least 13 vitamins for proper bodily functions. Eating the right food sources is a natural way to get these vitamins. However, getting vitamins and minerals from these food sources can be tricky when you have a Chronic Kidney Disease. The vitamins and minerals available in the market may exacerbate your kidney conditions since CKD patients have unique requirements for certain water-soluble vitamins.
If you are diagnosed with CKD, your nephrologist may prescribe vitamins along with medications to help support your kidneys. Doctors prescribe special renal vitamins that contain folic acid, niacin, biotin, B1, B2, B6, B12, folic acid, and a small dose of vitamin C. Your vitamin prescription will vary according to your level of kidney function, CKD stage, and other health conditions that could affect your kidney health.
Vitamins and Supplements for Kidneys: The Good and The Bad
Most vitamins and minerals come from the food you consume. The body cannot produce these substances. People with healthy kidneys can potentially get enough vitamins and minerals from a variety of foods they consume. However, people with CKD and/or those on dialysis have a special diet that may limit them from getting these vitamins and minerals.
Manifestations of nutrient deficiencies can result in health issues such as skin lesions, muscle weakness, nerve pain, and fatigue. Some kidney medications may not work well with particular vitamins. Furthermore, some water-soluble vitamins have certain requirements in order to go well with your kidney conditions. Your nephrologist can help you find out which vitamins and minerals you may need through your blood tests and checking your health history.
Do CKD patients need vitamins and minerals?
Your need for some nutrients changes when you have CKD. The waste buildup in your body and your medication can change the way your body uses vitamins and minerals. With a decline in kidney function, your body can no longer absorb and process foods properly. Following a CKD-friendly diet can also mean you miss out on certain vitamins and minerals from specific food groups. On days when you have a low appetite, you may not get the right amounts of vitamins and minerals for your daily needs. CKD can even change the body’s abilities to produce vitamins such as vitamin D. Moreover, if you are going through dialysis, you may lose some vitamins during the treatment.
B-Vitamin Deficiency and CKD
An online journal published by IOSR Journal of Dental and Medical Sciences revealed that CKD patients have a high prevalence of vitamin B12 deficiency with most of the patients studied manifesting neurological, hematological, and gastrointestinal symptoms. B Vitamin including vitamin B9 (folate) and vitamin B12 (cobalamin) are water-soluble vitamins responsible for normal cellular functions. Having a low b12 vitamin can lead to anemia, which means that the body doesn’t have enough red blood cells to perform its function. Vitamin B12 deficiency can also lead to nerve damage and affects memory and thinking.
Typical Vitamins Recommended for CKD
Consult with your nephrologist before taking any vitamins or supplements to avoid worsening your kidney condition. Vitamins are categorized into two – fat-soluble and water-soluble. As mentioned, CKD patients have a greater need for some water-soluble vitamins, as they don’t build up in the body. Water-soluble vitamins, therefore, should be replenished daily from the diet. Fat-soluble vitamins are more likely to build up in the body. These vitamins are vitamins A, D, E, and K, which must be taken with caution and ideally prescribed by your nephrologist.
Depending on your CKD stage, health conditions, and other factors, your nephrologist may suggest these vitamins:
Vitamin C can help heal bruises faster and keep body tissues healthy. It supports the immune system and prevents infection. Vitamin C may be recommended in low doses as large doses can build up oxalate in the bones and soft tissue.
Oxalate is a compound found in foods that are produced as a waste by the body. It leaves the body in the form of urine. Too much oxalate in the body can form kidney stones.
Your nephrologist will suggest if you need vitamin D based on your blood test that measures your calcium, phosphorus, and parathyroid hormone (PTH) levels. As your kidney condition progresses, your kidney’s ability to activate vitamin D is lost.
Vitamin D is essential in maintaining bone health, regulating parathyroid hormone, and absorbing calcium and phosphorus. Vitamin D can be taken as a pill or an injectable during a dialysis treatment if you are undergoing the treatment. You may be prescribed a specially activated vitamin D along with your blood work to monitor PTH and calcium levels.
Although B complex vitamins are grouped, each B Vitamin does a different job. Vitamins B1, B2, B6, B12, and folic acid team up with an iron to prevent anemia. Your nephrologist will decide if you need iron and its dosage.
When you have anemia, your body doesn’t have enough red blood cells to transport oxygen from the lungs to all parts of your body. B vitamins such as pantothenic acid (B5), and niacin (B3) help change the food you consume convert into energy that the body can use.
Iron is needed if you are treating anemia. It helps increase your blood cells and produce more hemoglobin – a protein needed to carry oxygen throughout the body.
Since damaged kidneys produce less erythropoietin, you may need to take an iron supplement. Erythropoietin is the hormone that stimulates the production of red blood cells in the body. Note that you should only take iron if and when your nephrologist prescribes it, just like the other vitamins.
Calcium supports bones' health yet too much calcium can clump together with phosphorus. The calcium-phosphorus deposits in places such as your heart, blood vessels, lungs, and other body tissues.
You may need to take a phosphorus binder if your blood phosphorus level is too high. Some phosphorus binder medications have calcium.
Medications to avoid when you have CKD
Certain medications can complicate your kidneys. NSAIDs or Non-steroidal anti-inflammatory drug has been linked to acute kidney injury. Although NSAIDs are effective for multiple medical problems, it is not a good medication when you have a CKD. Additionally, certain antibiotics are removed by the kidneys from the body. Taking antibiotics can overwork your kidneys. A few examples of antibiotics to watch out for include penicillin cephalosporins and sulfonamides. Even if your kidneys are healthy, long-term use of antibiotics can injure the kidneys. Those with CKD can suffer antibiotics buildup that can cause kidney damage.
It can be tempting to take dietary supplements to lose extra weight. However, since the Food and Drug Administration regulates these supplements as food and not drugs, some food supplement ingredients may not be listed on the label. These ingredients may interfere with your medications or kidney condition, leading to potential kidney damage. A review of 17 dietary supplements has been linked to direct kidney injury, although there is a very limited number of cases. Additionally, researchers found that patients often don’t discuss the dietary supplements they are taking with their doctors.
Therefore, hiding this detail from your doctor may put you at risk of adverse drug interaction and developing kidney injury.
The Bottom line
When you have CKD, your kidney function is compromised. You may have unique diet requirements, experience appetite loss, and go through changes that affect how your body absorbs and use vitamins and minerals. Vitamins and minerals can help support kidney health, but it is highly recommended to check with your nephrologist first before taking them. Ideally, your nephrologist will prescribe the necessary vitamin and mineral supplements along with the right dosage depending on your CKD stage, result of your blood work and other health condition. Consequently, you may also check in with your renal dietitian for possible dietary changes, so you can get these essential vitamins and minerals from natural food sources as well.