Vitamin B 6 deficiency may occur in patients with chronic kidney disease due to changes in diet and their body's inability to use vitamin B 6 effectively. Too little vitamin B 6 in the body can lead to erythropoietic protein therapy being less effective for treating anemia. 32
Nausea, headache, unusual skin sensations, sleepiness and low folic acid concentrations have been reported in patients receiving vitamin B6 supplements. In patients who have been receiving high-dose vitamin B6 therapy for a long time, nerve damage can occur. It is recommended that vitamin B6 treatment be withdrawn gradually.21
Vitamin B12 is essential for the healthy development of red blood cells. During dialysis, vitamin B12 can be lost but despite this, vitamin B12 deficiency is uncommon.23
When vitamin B12 supplementation is needed, oral doses can be used, or vitamin B12 injections can be administered.21
Vitamin B12 is usually non-toxic even in large doses, however, some side effects have been reported such as mild and transient diarrhea, itching skin and hives.21
A sufficient quantity of folic acid is necessary to maintain normal red blood cell production, as folic acid deficiencies can lead to various types of anemia. If erythropoietic protein therapy is not working effectively, too little folic acid may be to blame. 2
Measurement of folate within red blood cells indicates how much folate is stored in the cells, whereas an evaluation of folate in blood serum generally reveals the patient's overall nutrition.16
Folic acid is usually taken by mouth but in some cases it may also be administered by intravenous, subcutaneous, or deep intramuscular injection.21
The body's natural L-carnitine is produced in liver, kidney and brain tissue and is stored mainly in the muscles of the heart and skeleton.33, 34 In addition, L-carnitine can be obtained by eating certain foods, such as meat and dairy products.
L-carnitine deficiency may result in weakness, low blood pressure, heart problems, or recurrent cramps.35
If you have chronic kidney disease and are receiving dialysis, your physician may prescribe L-carnitine for you, either by mouth or intravenously.21
In patients with a history of seizures, an increase in seizure frequency and/or severity has been noted in patients receiving L-carnitine. During long-term oral use, various mild gastrointestinal complaints have been reported. Following intravenous administration, temporary nausea and vomiting, stomach problems and body odor have been reported.21
Vitamin C supplements taken by mouth can help increase absorption of iron 36 although in patients with chronic kidney disease, long-term vitamin C therapy has been avoided. Vitamin C doses higher than 250 mg/day are discouraged in these patients due to the risk of excessive calcium oxalate buildup and stone formation.
Vitamin C is usually administered by mouth, but may also be administered via intravenous or injection.21
Vitamin C does not usually cause any side effects but some people have reported experiencing gastrointestinal problems, fatigue, flushing, headache, and sleep disturbances. Higher doses may result in diarrhea and may increase the risk of renal stones in certain people.21
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