Fehrman-Ekholm Ingela, Lotsander Agneta, Logan Katarina, Dunge David, Odar-Cederlöf Ingegerd, Kallner Anders
Dialysis Unit, Sophiahemmet, Queen Sophia Hospital, Stockholm, Sweden.
Scand J Urol Nephrol. 2008;42(1):74-80. doi: 10.1080/00365590701514266.
Uncertainty has arisen as to whether vitamin supplements are needed by dialysis patients, in particular those treated by means of hemofiltration or hemodiafiltration using highly permeable (high-flux) filters. We therefore measured the concentrations of vitamin C, cobalamin (vitamin B12) and folic acid in conventional (low-flux) dialysis patients and in those receiving on-line treatment (hemofiltration or hemodiafiltration).
Plasma (P-)ascorbate, serum (S-)cobalamin and S-folate concentrations were measured before and after a treatment session in 15 patients treated with low-flux hemodialysis and in 14 treated with on-line hemofiltration or hemodiafiltration. The patients' vitamin supplementations were also recorded.
P-ascorbate concentrations were lowered by 51% and 53% in the hemodialysis and on-line groups, respectively after treatment and this reduction was significant (p<0.001). Concentrations below the reference values were found in 12/14 patients not receiving vitamin C supplementation. S-cobalamin did not decrease in the hemodialysis or on-line groups. S-folates did not change significantly in the hemodialysis or filtration groups. Patients without folacin supplementation had low values.
P-ascorbate was reduced by both dialysis and filtration treatments. Neither S-cobalamin nor S-folate were reduced by dialysis or filtration treatments.
对于透析患者，尤其是那些使用高通透性（高通量）滤器进行血液滤过或血液透析滤过治疗的患者，是否需要补充维生素存在不确定性。因此，我们测量了接受常规（低通量）透析治疗的患者以及接受在线治疗（血液滤过或血液透析滤过）的患者体内维生素C、钴胺素（维生素B12）和叶酸的浓度。
测量了15例接受低通量血液透析治疗的患者以及14例接受在线血液滤过或血液透析滤过治疗的患者在一次治疗前后的血浆（P-）抗坏血酸、血清（S-）钴胺素和S-叶酸浓度。还记录了患者的维生素补充情况。
治疗后，血液透析组和在线治疗组的P-抗坏血酸浓度分别降低了51%和53%，且这种降低具有显著性（p<0.001）。在12/14例未补充维生素C的患者中发现其浓度低于参考值。血液透析组和在线治疗组的S-钴胺素浓度均未降低。血液透析组或滤过组的S-叶酸浓度均未发生显著变化。未补充叶酸的患者其叶酸值较低。
透析和滤过治疗均会使P-抗坏血酸降低。透析或滤过治疗均未使S-钴胺素或S-叶酸降低。
