If you have chronic kidney disease (CKD), you may wonder whether you should be taking vitamins or supplements. While vitamins are essential for your overall health, CKD can change the way your body uses, stores, and removes certain nutrients.

Some vitamins may become too low, while others can build up to unsafe levels. In some cases, your healthcare team may recommend supplements to help fill nutritional gaps. In others, taking extra vitamins could do more harm than good.

The National Kidney Foundation explains which vitamins may be helpful, which ones require caution, and why it’s important to work closely with your healthcare team before starting any supplement.*

How Does CKD Affect Your Vitamin Needs?

Most of the vitamins your body needs come from the foods and drinks you consume each day. A balanced diet that includes fruits, vegetables, grains, dairy products, and proteins helps provide the nutrients your body needs to function properly.

However, CKD can make it harder to maintain the right balance of vitamins for several reasons:

• Your kidneys help regulate vitamin levels in the body. When kidney function declines, some vitamins may build up while others may become depleted.
• Dietary restrictions for protein, potassium, or phosphorus may reduce the variety of foods you can eat, making it harder to get enough vitamins.
• Waste products that build up in the blood can affect how your body processes nutrients.
• Dialysis removes some water-soluble vitamins during treatment.
• If you have received a kidney transplant, anti-rejection medications may affect vitamin levels.

Because every person with CKD is different, your healthcare provider or kidney dietitian may review your diet and blood test results to determine whether you need vitamin supplements.

Vitamins That May Be Recommended for People With CKD

Not everyone with CKD needs supplements, but some vitamins are commonly recommended.

B Vitamins

B vitamins help your body turn food into energy and support healthy nerves, tissues, and blood cells.

Different B vitamins have different roles:

• Vitamin B9 (folic acid) and vitamin B12 help your body make red blood cells and may be used as part of anemia treatment.
• Vitamin B1 (thiamine), B2 (riboflavin), B3 (niacin), B5 (pantothenic acid), B6 (pyridoxine), and B7 (biotin) help support energy production and nerve health.

Many kidney-specific multivitamins contain a combination of B vitamins designed for people with CKD.

Vitamin C

Vitamin C supports your immune system and helps wounds, cuts, and bruises heal.

While some people with CKD may benefit from vitamin C supplementation, taking too much can increase oxalate levels in the body. High oxalate levels may increase the risk of certain kidney stones, especially calcium oxalate stones.

Vitamin D

Vitamin D helps your body absorb calcium and maintain strong bones.

Healthy kidneys help activate vitamin D so your body can use it. As kidney disease progresses, especially in stage 4 or stage 5 CKD, your kidneys may no longer perform this function effectively.

If this happens, your healthcare provider may prescribe a special form of vitamin D, either as a daily pill or as an injection during dialysis treatments.

Iron

Although iron is a mineral rather than a vitamin, it is often part of anemia treatment for people with CKD.

If blood tests show that your iron levels are low, your healthcare provider may recommend iron supplements or iron infusions to help your body make healthy red blood cells.

Vitamins and Supplements That May Need to Be Limited

More is not always better when it comes to vitamins. Some vitamins can accumulate in the body and become harmful if taken in large amounts.

Vitamin A

Most people with CKD get enough vitamin A through food and do not need supplements.

Because vitamin A is stored in the body, excess amounts can build up over time and potentially cause harmful side effects.

Vitamin E

Vitamin E is another fat-soluble vitamin that can accumulate in the body. Unless your healthcare provider specifically recommends it, vitamin E supplements are generally not needed.

Vitamin K

Vitamin K is important for blood clotting, but supplements are usually unnecessary unless prescribed by your healthcare provider.

Calcium

Calcium is important for bone health, but taking too much can be harmful for people with CKD.

Excess calcium may combine with phosphorus and deposit in blood vessels, the heart, lungs, and other tissues. For this reason, calcium supplements should only be taken under the guidance of your healthcare team.

Should You Take a Multivitamin?

Many people assume a daily multivitamin is automatically beneficial, but that is not always true for people living with CKD.

A multivitamin may:

• Contain vitamins you do not need
• Provide doses that are too low to correct a deficiency
• Include ingredients that may not be appropriate for kidney disease

Some people benefit from kidney-specific multivitamins that are formulated with the needs of CKD patients in mind. Others may do better with individual supplements based on their blood work and health history.

Your healthcare provider or kidney dietitian can help determine which approach is best for you.

Questions to Ask Your Healthcare Team

If you’re unsure whether you need vitamins, consider asking:

• Do I need any vitamin supplements?
• Are my current vitamin levels too low or too high?
• Can I meet my vitamin needs through diet alone?
• Should I take an over-the-counter supplement or a prescription product?
• Is a kidney-specific multivitamin right for me?
• Are there any vitamins or supplements I should avoid?

Conclusion

Vitamins play an important role in keeping your body healthy, but CKD can change how your body processes and uses them. While some people may benefit from supplements such as B vitamins, vitamin D, vitamin C, or iron, others may need to avoid certain vitamins that can build up and cause harm.

The safest approach is to work closely with your healthcare provider and kidney dietitian. Together, they can use your diet, health history, and lab results to determine which vitamins you need—and which ones you should avoid.

Remember: vitamins are medicines, too. Always check with your healthcare team before starting any new supplement.

*National Kidney Foundation. (Last updated August 26, 2025). “Vitamins in Chronic Kidney Disease.” kidney.org