Vitamin nutrition in patients on continuous ambulatory peritoneal dialysis (CAPD)

In 10 patients who had been on CAPD for 8.75 months, blood levels of the vitamins A, E, B-complex and C were measured and a precise diet history using food weighing for 3 days was obtained. Plasma vitamin A was elevated in all; since retinol binding protein (RPB) was elevated even more, the ratio of retinol to RBP was low. Vitamin E levels were also high. The vitamins B1, B2 and B6 were measured using erythrocyte enzyme activities. Vitamin B1 was low or borderline in 5, vitamin B6 was decreased in 3 and erythrocyte pyridoxal phosphate in 8 patients. Folic acid was low or borderline in 6 patients, whereas the vitamins B2 and B12 were normal in all. Vitamin C was diminished in 4 patients, and in dialyzate 60% of plasma concentrations were found. The intakes of the vitamins B1, B6 and B12 were below the recommended range. After supplementation of water soluble vitamins for 7 weeks the vitamins A and E remained elevated and B1 remained low, B6 and C had normalized in all and folic acid was markedly elevated. In CAPD decreased blood concentrations of some water soluble vitamins are found due to insufficient dietary intake and loss into dialyzate. Tentative recommendations are given for the replacement of the vitamins B1, B6, folic acid and C.