Just saw this post on the Renal Fellow’s Network. I appreciate his flippant attitude toward renal vitamins as they are so routine as to invite disregard but they may have an effect on mortality.
This 2004 article based on the DOPPS database shows a significant reduction in mortality (RR 0.84) associated with use of water soluble vitamins.
I always have a healthy skepticism for DOPPS data as they have been on the wrong side of the anemia, Kt/V and statin debate. Each time being refuted by the RCT. But I’ll take the position that since no one will ever do a randomized controlled trial we should go forward with the renal vitamins.
I first heard about this data on renal vitamins during the at the Easterling Lecture given by Eric Young for the Michigan NKF in 2003. At the time this was explained by the reduction of homocysteine induced by the folate in the vitamin. Since that has also fallen to the blade of the RCT, I wonder what componant of the renal vitamin explains the benefit.
Interesting post, and thanks for the comment on my own blog.
Good to know that there is indeed some data for the use of water-soluble vitamins since they are so frequently prescribed.
I can see why there is a deficiency of water-soluble vitamins in ESRD patients–many are smaller molecules which are likely dialyzed off–but how to explain the deficiency in CKD patients? Decreased appetite?
I also prefer eVitamins for all vitamin supplements.