Vitamins and Minerals for People with Kidney Disease

The need for vitamins and minerals can be met through diet for most healthy people. Kidney disease and the treatments for it can changes the availability and requirements for certain nutrients. Read on to find out more about how kidney disease impacts your need for vitamins and minerals.

What are vitamins and minerals?

Vitamins and minerals are key factors that our bodies use to make energy, promote growth and repair body tissues (1). Vitamins and minerals are found in the food we eat, so the best way to get them is by eating a well-balanced, nutrient-dense diet. For many chronic kidney disease (CKD) and dialysis patients, achieving adequate nutrient intake by diet alone may be difficult and trying to figure out what to eat may be a challenge.

Are nutrient needs different for individuals with CKD and those on dialysis?

A decline in kidney function causes waste products to collect in the body which can change the way the body uses nutrients. Those with kidney disease may have an impaired ability to make or use certain vitamins – vitamin D for example. Medication may also change the way the body uses vitamins and minerals. When a person receives dialysis some vitamins are lost during treatment. All of these factors may lead to an increased or decreased need for certain nutrients.

How do I know if I need to supplement my diet with a renal vitamin?

Sometimes a diet recall or food diary is all that is needed to identify nutrient insufficiencies. Other times a more comprehensive assessment which includes bloodwork, may be needed to identify specific nutrient deficiencies. Many individuals with CKD can benefit from supplementation that provides the recommended daily allowance (RDA) of water-soluble vitamins (2). Over the counter (OTC) multivitamin and mineral supplements typically are not the best choice for individuals with CKD or those on dialysis. These may have an imbalance of the nutrients people with kidney disease require.

There are special vitamin formulations for patients with kidney disease called renal vitamins . Your dietitian or health care provider will determine which formulation is best for your individual needs. Vitamin recommendations for CKD and dialysis patients usually include water-soluble vitamins, such as vitamin C and the B vitamins. Fat-soluble vitamins – A, D, E and K are usually not recommended for daily use unless a vitamin deficiency has been identified.

If a renal vitamin is recommended for you and you are a dialysis patient it is best if you take the vitamin after your dialysis treatment. Renal vitamins are water-soluble vitamins so if you take the vitamin before dialysis the vitamins will be removed during the dialysis treatment.

Vitamin and mineral recommendations for CKD patients (3)

If you have kidney disease but are not on dialysis your doctor will prescribe vitamin or minerals supplements if needed. It’s important to follow guidelines specific to your individual needs. For kidney disease stages 1-4 general guidelines are:

• Ensure adequate nutritional vitamin D
• Meet the Daily Reference Intakes (DRI’s) for B-complex and C
• Iron and zinc if deficiencies are detected

Vitamin and mineral recommendations for dialysis patients (3)

• Vitamin C – 60-100mg/day
• B6 – 2mg/day
• Folate – 1-5mg/day
• B12 – 3 mcg/day
• B1 (thiamine) – 1.5mg/day – 2mg may be needed for Peritoneal Dialysis (PD)
• Iron –varies based on blood test results
• Zinc – 15mg/day
• Vitamin D – varies based on blood test results
• Vitamin E – 15 IU/day
• Other vitamins – RDA unless specified

What about herbal supplements?

At any stage of kidney disease, it is best to avoid herbal supplements. This is because of potential interactions with prescription medication, over the counter medications, supplements and potential unwanted side effects. Before using any herbal supplement, vitamin or mineral or nutrition supplement please talk to your dietitian or health care provider to make sure it is safe.

References:

1. A Current Look at Renal Multivitamins. Swafford, Christine. J. Ren. Nutr Vol 2011; e33-e42
2. Handelman, GJ, Levin, NW. Guidelines for supplements in chronic kidney disease patients: What is the evidence? J. Ren. Nutr. 2011; 21: 117–
3. McCann L. Pocket Guide to Nutrition Assessment of the Patient with Chronic Kidney Disease 5^th ed. National Kidney Foundation; 2015.

This article is for informational purposes only and is not a substitute for medical advice or treatment. Consult your physician and dietitian regarding your specific diagnosis, treatment, diet and health questions.

Additional Kidney Diet Resources

Visit DaVita.com and explore these diet and nutrition resources:

DaVita Food Analyzer

DaVita Dining Out Guides

Today’s Kidney Diet Cookbooks

DaVita Kidney-Friendly Recipes

Diet and Nutrition Articles                                                      

Diet and Nutrition Videos

Kidney Smart® Virtual Classes

This article is for informational purposes only and is not a substitute for medical advice or treatment. Consult your physician and dietitian regarding your specific diagnosis, treatment, diet and health questions.