A Guide to Good Nutrition - Vitamin and Mineral

A diet low in sodium, potassium, and phosphorus can be a diet low in certain vitamins and minerals. This section includes the vitamins and minerals which are important for you. You will need more of some of these vitamins and minerals and less of others.

When you finish this section, you will know why you need to take certain supplements, and why others may not be right for you.

THERE ARE SOME VITAMINS THAT YOU NEED DAILY. Some vitamins are removed during dialysis treatment because of the cleaning of the blood. For dialysis patient, vitamins are considered prescription medicine and should only be taken with your doctor's orders. Usually one vitamin pill contains several vitamins. Get the vitamin pill you are now taking and check off the vitamins in it.

Vitamins	Information
B₁ (thiamin) B₂ (riboflavin) B₆ (pyridoxine) B₁₂ (cobalamine) Biotin C (ascorbic acid) Folic acid Niacin	You may be limiting your intake of these vitamins due to limits you have on high potassium foods. These vitamins are also removed during dialysis.

HOW DOES YOUR VITAMIN SUPPLEMENT STACK UP? Do you get the vitamins that you need? If not, you can discuss your vitamin needs with your doctor or nutritionist.

Other Nutrients May Need to be Supplemented
Some Vitamins and Minerals Need to be Avided
Decisions, Decisions ....

OTHER NUTRIENTS MAY NEED TO BE SUPPLEMENTED. These are prescription medicines and should only be taken with your doctor's prescription. Check off the supplements that you are taking now.

Vitamins	Information
Vitamin D₃, other names are: Rocaltrol Calcitriol	The kidney normally changes vitamin D in foods into the active form called vitamin D₃. D₃ helps you absorb calcium. A supplement of the active form of vitamin D, Calcitriol or Rocaltrol, is recommended when calcium supplements alone do not raise low blood-calcium levels. Too much vitamin D may lead to calcium buildup in blood and body tissues.

Minerals
Calcium, other names are: Calcium acetate Calcium carbonate Tums	Your diet may be low in calcium because you limit high-phosphorus milk products that are also high in calcium. Sometimes calcium supplements are used in large doses as phosphate binders.

Iron, other names are: Ferrous sulfate Ferrous gluconate	Low iron levels may be caused by small amounts of blood loss in dialysis, or by low iron in the diet. Both of these problems can cause anemia.

Zinc, other names are: Zinc sulfate	Some people on dialysis may benefit from taking this supplement, if their diet is low in zinc.

SOME VITAMINS AND MINERALS NEED TO BE AVOIDED. The following supplements should not be taken except as prescribed by your doctor.

Vitamins	Information
Vitamin A	People on dialysis often have blood levels of vitamin A that are normal or high. Usually you don't need a supplement. High levels are toxic. Many multiple vitamin supplements contain vitamin A. Read labels carefully.

Minerals	Information
Aluminum	Aluminum is not dialyzed out of your blood. Products containing aluminum should not be used unless prescribed. High levels are toxic. One example of a medicine often prescribed with aluminum is phosphate binders.
Magnesium	Magnesium is not removed either, so you do not need supplements of this. Products containing magnesium should not be used unless prescribed. High levels are toxic. Examples are Milk of Magnesia and Mallox.
Phosphorus	Phosphorus does not dialyze out, so you do not need supplements of this. Some vitamin-mineral supplements contain phosphorus. Do not use these products unless prescribed by your doctor.

Decisions, Decisions...

What about other vitamins and minerals? For many vitamins, the effects of kidney failure and dialysis are not known. It is best to avoid extra vitamin and mineral supplements. Check with your nutritionist or doctor if you have questions.

Supplementing yourself with excess vitamins or supplements may decrease the effect of other important nutrients in your blood. Balance is the key.

Below are some ideas to try. Check the ones you think would be helpful:

Low cost combinations of vitamins and minerals are available. When shopping around make sure the one you choose contains only the amounts prescribed.

Constipation, which may be caused by some mineral supplements, can be relieved by adding bran fiber to your diet. For other tips, see the "Relief of Constipation" section of your nutrition workbook.

Nausea may be caused by some vitamin and mineral supplements. Sometimes asking your doctor to change supplements or brands may help. Taking the vitamin before bed may also help.

Timing is important. Vitamin supplements are best used by your body if taken after dialysis, rather than before. Mineral supplements should be taken one hour before meals or two hours after meals, but it may be a good idea to eat a small amount of food with mineral supplements if they bother your stomach.

Now look back at your own supplements of vitamins and minerals. Make a note what time to take them. Check with your doctor, nurse, or pharmacist to help you plan when to take your medications.

Why learn about Vitamins and Minerals?

Your body's vitamin and mineral levels may be affected by your diet, kidney function, and dialysis. Low levels of vitamins and minerals may reduce your ability to fight disease and infection. Taking your vitamins and minerals as prescribed will give you the best chance of staying healthy.

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