Vitamins and quality of life in hemodialysis patients.

Background: Dialysis patients have decreased quality of life compared to healthy controls. In recent years the quality of life in hemodialysis patients has been considered from many points of view. The aim of this retrospective study was to improve quality of life in dialysis patients by supplementing some important vitamins.

Patients And Methods: Eighty-three patients underwent hemodialysis treatment 3 x 4 hr/weekly using a standard dialyzer with a cellulose membrane. During the investigation of plasma and erythrocyte vitamin E, vitamin E-coated dialyzer was used. Patients who were treated with erythropoietin (EPO) were supplemented over 3 months with Pyridoxine: 20 mg/day, folic acid: 10 mg/week, vitamin C: 60 mg/day. Some erythrocyte and plasma vitamins and plasma malondialdehyde were investigated in all patients. Erythrocyte vitamin B6 was determined by indirect enzymatic method as an effect of pyridoxal-5-phosphate (PLP). Erythrocyte folic acid was determined by radioimmunoassay method, erythrocyte vitamin E and plasma malondialdehyde were determined by fluorometric methods, plasma vitamin C was determined by spectrophotometric method.

Results: During above mentioned EPO treatment and supplementation, vitamins significantly increased blood hemoglobin (from 100+/-5 to 110+/-4 g/L, p<0.05), erythrocyte vitamin B6 that means decreased effect of PLP (from 30.4+/-2.4 to 16.4+/-1.9%, p<0.01), increased erythrocyte folic acid (from 343.3+/-72 to 734.5+/-98 ng/mL) and plasma vitamin C (from 63.5+/-15 to 88.3+/-10 micromol/L). Three-month use of vitamin E-coated dialyzer led to the increase of erythrocyte vitamin E (from 6.7+/-0.5 to 7.4+/-0.4 micromol/L, p<0.05) and to the significant decrease of plasma malondialdehyde (from 2.8+/-0.5 to 2.2+/-0.4 micromol/L, p<0.01).

Conclusions: 1. Investigated vitamins were decreased in hemodialysis patients and after supplementation increased to normal range. 2. Increased plasma malondialdehyde, as a product of lipid peroxidation, significantly decreased during the use of vitamin E-coated dialyzer. 3. Adequate supplementation of above mentioned vitamins led to increased quality of life in hemodialysis patients from some clinical points of view.