Effects of Large Dose Vitamin E Supplementation on Anemia in Hemodialysis Patients

Ono, Keiji

doi:10.1159/000183516

Cited by 44 publications

(21 citation statements)

References 21 publications

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“…These findings have been replicated in several other studies performed outside the US 55,57,61,62 , though not all concur 58 .…”

Section: Evidence For Altered Requirements In Hemodialysis Patientssupporting

confidence: 56%

Is Routine Multivitamin Supplementation Necessary in US Chronic Adult Hemodialysis Patients? A Systematic Review

Tucker

Safadi

Friedman

2015

Journal of Renal Nutrition

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“…These findings have been replicated in several other studies performed outside the US 55,57,61,62 , though not all concur 58 .…”

Section: Evidence For Altered Requirements In Hemodialysis Patientssupporting

confidence: 56%

Is Routine Multivitamin Supplementation Necessary in US Chronic Adult Hemodialysis Patients? A Systematic Review

Tucker

Safadi

Friedman

2015

Journal of Renal Nutrition

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“…Again, deficiency of vitamin E is a common feature in genetic anemia, including G6PD deficiency hemolytic anemia due to its increased consumption 8,9 . Supplementation of vitamin E may have an important role in maintaining red cell membrane integrity by reducing osmotic fragility of erythrocyte 10,11 and can minimize the severity of hemolysis in G6PD deficient patients 12 . Again, vitamin E supplementation can restore the required amount of vitamin E level in this group of patients, and thus may prevent hemolysis by improving red blood cells survival 5,6,13 .…”

Section: Introductionmentioning

confidence: 99%

“…Study of the changes in osmotic fragility of RBC and MCV, MCH, MCHC is important as it may reflect the hemolytic crisis in G6PD deficient patients. Evaluation of supplementation of vitamin is equally important in these cases 10,11 .…”

Section: Introductionmentioning

confidence: 99%

Effects of Oral Supplementation of Vitamin E on Fragility of RBC in Hemolytic Anemic Patients with G6PD Deficiency

Sultana¹,

Begum

et al. 2009

Bangabandhu Sheikh Mujib Medical University Journal

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Abstract:Background: Vitamin E has role in maintaining the integrity of red cell membrane by preventing oxidation of polyunsaturated fatty acids and thereby protects cells from oxidative stress-induced lysis in G6PD deficiency, which can be reflected by changes in osmotic fragility of RBC and some absolute values like MCV, MCH & MCHC. Objective: To observe the effects of vitamin E supplementation on fragility of RBC in order to evaluate role of this antioxidant vitamin in reducing chronic hemolysis in G6PD deficient patients. Methods: For this, a total number of 102 subjects with age ranged from 5 to 40 years of both sexes were included in the study. Among them 68 were G6PD enzyme deficient patients, of whom 34 were in supplemented group (study group) and 34 were in non-supplemented group (control group). The supplemented group received vitamin E supplementation for 60 consecutive days at a dose of 800 IU/day for adult and 400 IU/day for children < 12 years (in a divided dose i,e. 4 times daily). Age and sex matched 34 apparently healthy subjects with normal blood G6PD level were taken to observe the base line data (healthy control) and also for comparison. All the G6PD deficient patients were selected from Out Patient Department (OPD) of Hematology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh during the period of July 2005 to June 2006 and all the healthy subjects were selected from personal contact. Blood G6PD level, osmotic fragility of RBC were measured by standard techniques and MCV, MCH, and MCHC were obtained by calculation. All the parameters were measured on day 1 (one) of their first visit and also were on day 60 in deficient group. Data were compared among the deficient groups, also in supplemented group just before and after supplementation. Analysis of data was done by appropriate statistical method. Results: Mean starting and completing points of osmotic fragility of RBC were significantly higher but MCV, MCH, MCHC were significantly lower in patients suffering from hemolytic anemia due to G6PD deficiency in comparison to those of the healthy control. After supplementation with vitamin E starting and completing points of osmotic fragility of RBC were significantly decreased whereas, MCV, MCH, MCHC were significantly increased towards those of healthy control in supplemented group of patients in comparison to those of their pre-supplemented (day-1) and non-supplemented groups both on day 1 and day 60. Conclusion: From this study it may be concluded that, disturbances of some of the hematological parameter like higher osmotic fragility of RBC and lower MCV, MCH, MCHC occur in G6PD deficient hemolytic anemic patients, which returned towards normal after supplementation of vitamin E, which clearly indicates the role of this anti-oxidant vitamin in maintaining red cell membrane integrity and thereby decreases the rate of hemolysis in this group of patients. So, vitamin E can be supplemented along with other drugs for better management of the patients.

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“…However, despite normal serum vitamin E levels, RBC vitamin E levels have been reported risk of myocardial infarction, shunt failure, and muscle weakness [16]. The wide range in the dietary intake of to be low in chronic hemodialysis patients and can be corrected by vitamin E supplementation [22]. Until addivitamin C complicates efforts to recommend a standard dose of supplementation in hemodialysis patients.…”

mentioning

confidence: 99%

Vitamin Replacement Therapy in Renal Failure Patients

Makoff

1999

Mineral Electrolyte Metab

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Renal failure patients require vitamin replacement therapy that addresses the specialized needs of renal failure. Four factors including restricted diet, uremic toxins, drug-nutrient interactions, and in ESRD, the dialysis process, affect the normal absorption, retention and activity of necessary micronutrients which support all aspects of carbohydrate, protein, lipid and nucleic acid metabolism. Studies have shown that the typical renal failure diet is low in B vitamins, that uremic factors affect folate and pyridoxine activities and that many B vitamins are lost on dialysis at a rate greater than are lost with normal urinary excretion. In addition, retention of vitamin A or inappropriately high supplementation of vitamin C may cause toxicities which exacerbate existing pathologies. Further, emerging research suggests some vitamins such as folic acid and pyridoxine, if provided in higher than normal amounts, may have an impact on reducing the risk of some aspects of renal cardiovascular disease. It is therefore important to supplement some vitamins, and use restraint in the supplementation of others. It is clear that renal failure patients, including predialysis, ESRD and transplant patients need specialized supplementation that meets the requirements of disease and its management.

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Effects of Large Dose Vitamin E Supplementation on Anemia in Hemodialysis Patients

Cited by 44 publications

References 21 publications

Is Routine Multivitamin Supplementation Necessary in US Chronic Adult Hemodialysis Patients? A Systematic Review

Is Routine Multivitamin Supplementation Necessary in US Chronic Adult Hemodialysis Patients? A Systematic Review

Effects of Oral Supplementation of Vitamin E on Fragility of RBC in Hemolytic Anemic Patients with G6PD Deficiency

Vitamin Replacement Therapy in Renal Failure Patients

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