Hypervitaminosis A in a patient with alopecia receiving renal dialysis

A patient with gradually increasing hair loss was undergoing long-term renal dialysis. Questioning revealed that her supplemental vitamin program had contained vitamin A only to that extent it was included in a portion of multivitamins taken in conventional amounts for approximately three years. Her serum vitamin A level was 140 micrograms/dL (a normal level is 20 to 80 micrograms/dL). Reports have indicated that chronic renal disease results in a state of relative hypervitaminosis A. This is compounded in renal dialysis by failure to remove vitamin A. The administration of low-dose supplemental vitamin A preparations in this select population is discussed with respect to current concepts of vitamin A metabolism in renal disease.