Vitamins and minerals are essential for your body to carry out major functions. If you have chronic kidney disease (CKD), you may be deficient in certain vitamins and minerals. One such example specifically applies to people on dialysis, as dialysis requires certain foods to be limited or avoided altogether. You may need to take supplements to regain the vitamins and minerals you may not have enough of nor get from your daily nutrition.*

How does kidney disease affect your nutrient needs?

There are several ways CKD can affect the way your body absorbs and uses nutrients:

• Waste products can build up in your body and change the way your body uses vitamins and minerals. 
• If you’re being treated for CKD with medications or a special diet, your body may need more or less of certain nutrients.
• Some vitamins are lost during dialysis treatment.

What vitamins and minerals may be affected?

You may need to replenish your nutrient stores of the following vitamins and minerals, which can be lowered by CKD or your treatment method for CKD:

• B complex: B complex vitamins are grouped together, but each B vitamin plays a different role. Vitamin B6, B12, and folic acid work with iron to prevent anemia, which means a person has insufficient red blood cells. Red blood cells carry oxygen from your lungs to all parts of your body. Other B vitamins, like thiamine, riboflavin, pantothenic acid, and niacin, can also be given as a supplement to give your body energy.
• Iron: Treatment for anemia may require an iron pill or injection, as prescribed by your healthcare provider.
• Vitamin C: Vitamin C is used for immune health and promotes wound and bruise healing. 
• Vitamin D: Vitamin D maintains healthy bones. A vitamin D pill or injection may be prescribed during your dialysis treatment. Your healthcare provider will customize your dose to your needs.
• Calcium: Calcium helps the absorption of vitamin D, but it is important to take no more calcium than what is prescribed by your healthcare professional or renal dietitian. 

What supplements should I limit?

You may also need to avoid certain vitamins, such as:

• Vitamin A
• Vitamin E
• Vitamin K

All three can build up in the body and cause harm, such as dizziness, nausea, and, in some cases, death. Vitamin C levels should also be monitored; too much vitamin C can cause high levels of oxalate, which can cause pain over time.

Calcium levels should also be monitored. Too much calcium can combine with phosphorus in certain places in the body, like your heart, blood vessels, lungs, and other bodily tissues. If your blood phosphorus level gets too high, you may need to take additional medication, such as phosphate binders, to reduce your levels.

Your healthcare professional and renal dietitian will analyze your health history and order specific blood tests to find out which foods or supplements you may need. Make sure to speak to your care team before starting any new supplements, too, including herbal remedies, as they can impact kidney health.

*National Kidney Foundation. (2019, May 31). Vitamins and Minerals in Chronic Kidney Disease. https://www.kidney.org/atoz/content/vitamineral