Vitamin supplementation for dialysis patients is still controversial. In our study, we followed longitudinally over a period of a year, 15 patients on chronic hemodialysis who were deprived of vitamin supplementation. Microbiological assays were used to determine the levels of five vitamins of the B group (folate, niacin, B12, B6, and thiamine). Vitamin C was measured chemically. During the observation period when vitamins were not supplemented, a marked drop of many of these vitamins in blood levels were encountered. For vitamins B12 and C, the plasma levels remained within the normal range in all the subjects studied. For the other vitamins, the blood levels were found to be low in a few patients. Our data suggest that vitamin supplementation is probably not needed in most stable hemodialysis patients as it is recommended now, and that perhaps, if supplementation is indicated, less should be given than is presently prescribed. Further research is needed in this area.

Objective: To compare bone status of small-for-gestational age (SGA) versus appropriate-for-gestational age (AGA) newborn preterm infants.Study Design: Tibial speed of sound (SOS) was measured in 144 infants categorized as SGA or AGA using the reference tables of Lubchenco et al. and Alexander et al.Result: By the Lubchenco tables, 22% of infants were SGA and 75% were AGA. The mean gestational ages of SGA and AGA were similar (33.3±2.6 and 32.5±2.4 weeks, respectively, P ¼ 0.09); however, SGA infant birth weights were lower (1329±392 and 1829±481 g, respectively, P<0.001). SOS values were higher for SGA versus AGA infants (3098±135 and 3003±122 m/s, respectively. P<0.001). Use of the Alexander tables yielded a twofold increase in the percent of infants categorized as SGA; SOS values remained significantly greater for SGA infants (P<0.001). Conclusion:Higher tibial SOS values in SGA versus AGA infants indicate greater bone strength.