Vitamin and trace element concentrations in infants and children with chronic kidney disease

Abstract

Background There are limited data regarding vitamin and trace element blood concentrations and supplementation needs in children with non-dialysis stages 3-5 of chronic kidney disease (CKD). Methods Retrospective cross-sectional review for nutritional blood concentrations measured over a recent 2-year period. In our CKD clinics, nutritional bloods including copper, zinc, selenium and vitamin A, vitamin E, active vitamin B 12 and folate are monitored annually. Vitamin D status is monitored every 6-12 months. Results We reviewed 112 children (70 boys) with median (IQ1, IQ3) age 8.97 (4.24, 13.80) years. Estimated median (IQ1, IQ3) GFR (mL/min/1.73 m 2) was 28 (21, 37). Vitamin A, active vitamin B 12 and vitamin E concentrations were within normal range in 19%, 23% and 67% respectively, with all others being above normal range. Vitamin D blood concentrations were within desired range for 85% (15% had low levels) and folate blood concentrations were within normal range in 92%, with the remainder above or below target. For trace elements, 60%, 85% and 87% achieved normal ranges for zinc, selenium and copper respectively. Deficiencies were seen for zinc (35%), copper (7%), folate (3%) and selenium (1%), whilst 5%, 6% and 14% had zinc, copper and selenium levels above normal ranges. Conclusions Several vitamin and trace element blood concentrations were outside normal reference ranges. Monitoring vitamin D and zinc blood concentrations is indicated due to the percentages with low levels in this group. Targeted vitamin and trace element supplementation should be considered where indicated rather than commencing multivitamin and/or mineral supplementation.

Association between Selenium Status and Chronic Kidney Disease in Middle-Aged and Older Chinese Based on CHNS Data

“…Diabetes, hypertension, obesity, hyperlipidemia, advanced age, and smoking have been identified as traditional risk factors for CKD [4]. Trace elements such as zinc, manganese, iron, and selenium have also been reported to be involved in the progression of CKD [5][6][7].…”

Vitamin D level in children with chronic kidney disease on conservative treatment – a pilot study

“…If indicated, vitamin D supplementation should be provided in infants and children with CKD. Targeted supplementation is preferable instead of multivitamin and multimineral one [12].…”

Role of Vitamin E in Boosting the Immunity from Neonates to Elderly

“…The children suffering from chronic kidney disease are at high risk of micronutrient deficiency. The concentration of vitamin A and vitamin B12 was within the range of reference while vitamin E shows major changes as the kidney disease worsens hence advance studies are essential to determine the required concentration of vitamin supplements in infants and children with this disease [35]. In children, respiratory tract infection is common cause of the morbidity.…”