Does High-Flux Haemodialysis Increase Vitamin B Loss? - European Medical Journal

Does High-Flux Haemodialysis Increase Vitamin B Loss?

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ALTHOUGH vitamin B loss has been linked to haemodialysis, this has not been fully demonstrated consistently, and the effect of high-flux haemodialysis (HFHD) is also inconclusive. Therefore, the research team led by Yan Wang, Peking University People’s Hospital, Beijing, China, sought to identify the loss of Vitamin B1, B3, B5, and B6 in a single haemodialysis session and to specifically consider the effect of HFHD on vitamin B removal.  

Patients on maintenance haemodialysis were enrolled into the study, resulting in the inclusion of 76 patients categorised into either low-flux haemodialysis and HFHD groups. Vitamin B1, B3, B5, and B6 concentrations were measured using a blood test before and after hemodialysis sessions. The association between HFHD and vitamin B loss was investigated using multivariable linear regression analyses. The two patient groups were also compared.  

Results showed that the median reduction ratios of serum vitamins B1, B3, B5, and B6 were 38.1%, 24.9%, 48.4%, and 44.7%, respectively, following a single haemodialysis session. Furthermore, the median concentration of the same vitamins in the dialysate was 0.3 μg/L, 2.9 μg/mL, 2.0 μg/L, and 0.4 ng/mL, respectively. However, the researchers failed to identify a difference in reduction ratio or dialysate concentration between low-flux haemodialysis and HFHD groups.  

Overall, the research team concluded that vitamins B1, B3, B5, and B6 can be removed by haemodialysis but HFHD does not increase this loss. Wang and colleagues commented: “This result suggests that chronic haemodialysis patients are prone to have vitamin B deficiencies without supplementation regardless of the modality.” This is especially significant since “patients on haemodialysis are at risk for vitamin B deficiency for several reasons, including insufficient dietary intake, imposed dietary limitation, improper absorption of vitamins, use of certain medications, and vitamin loss during haemodialysis treatment.” 

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