Demand for Water-Soluble Vitamins in a Group of Patients with CKD versus Interventions and Supplementation-A Systematic Review.

BACKGROUND: Increasingly, chronic kidney disease (CKD) is becoming an inevitable consequence of obesity, metabolic syndrome, and diabetes. As the disease progresses, and through dialysis, the need for and loss of water-soluble vitamins both increase. This review article looks at the benefits and possible risks of supplementing these vitamins with the treatment of CKD. METHODS: Data in the PubMed and Embase databases were analyzed. The keywords "chronic kidney disease", in various combinations, are associated with thiamin, riboflavin, pyridoxine, pantothenic acid, folates, niacin, cobalamin, and vitamin C. This review focuses on the possible use of water-soluble vitamin supplementation to improve pharmacological responses and the overall clinical condition of patients. RESULTS: The mechanism of supportive supplementation is based on reducing oxidative stress, covering the increased demand and losses resulting from the treatment method. In the initial period of failure (G2-G3a), it does not require intervention, but later, especially in the case of inadequate nutrition, the inclusion of supplementation with folate and cobalamin may bring benefits. Such supplementation seems to be a necessity in patients with stage G4 or G5 (uremia). Conversely, the inclusion of additional B6 supplementation to reduce CV risk may be considered. At stage 3b and beyond (stages 4-5), the inclusion of niacin at a dose of 400-1000 mg, depending on the patient's tolerance, is required to lower the phosphate level. The inclusion of supplementation with thiamine and other water-soluble vitamins, especially in peritoneal dialysis and hemodialysis patients, is necessary for reducing dialysis losses. Allowing hemodialysis patients to take low doses of oral vitamin C effectively reduces erythropoietin dose requirements and improves anemia in functional iron-deficient patients. However, it should be considered that doses of B vitamins that are several times higher than the recommended dietary allowance of consumption may exacerbate left ventricular diastolic dysfunction in CKD patients. CONCLUSIONS: Taking into account the research conducted so far, it seems that the use of vitamin supplementation in CKD patients may have a positive impact on the treatment process and maintaining a disease-free condition.

Nutrition and lifestyle in patients pharmacologically treated due to hypertension.

BACKGROUND: Proper nutrition and physical activity are together an important way of non-pharmacological treatment of arterial hypertension. The aim of the study was to answer the question whether patients with hypertension use non-pharmacological methods of hypertension treatment. METHODS: The study included a group of 280 patients aged 18-85, suffering from hypertension. In the study, 10 nutritional and non-nutritional factors affecting the treatment of hypertension were analyzed. Data regarding the diet were collected by a method of 24-h recall. Basic anthropometric measurements (body weight, body height, waist and hip circumference) were taken, as well as threefold measurement of blood pressure. The data were statistically analyzed. RESULTS: The average value of blood pressure was 131.2 ± 15.5/82.9 ± 10.5 mm Hg. Approximately 90% of the respondents had abnormal body weight, i.e. excessive weight or obesity. Abdominal obesity according to waist hip ratio assessment was diagnosed in 87% of women and 66% of men; according to the measurement of waist circumference, it was diagnosed in 140 (81%) women and 88 (81%) men. Among the ingredients with antihypertensive effect, the sodium intake was 4,417.8 ± 2,052.7 mg/d, which when converted to salt is on average 11 g/d, potassium: 3,808.5 ± 1,265.7 mg/d, calcium: 724.6 ± 413.7 mg/d, and magnesium: 383.9 ± 139.3 mg/d. One in 5 (18%) people declared smoking. Only 5% of subjects reported high level of physical activity. CONCLUSIONS: In persons with diagnosed hypertension, vast majority of patients did not implement non-pharmacological hypertension treatment.