Department of Nephrology, Dialysis and Nutrition, Hospices Civils de Lyon, Lyon Sud Hospital, 69495 Pierre Bénite, France.
Department of Biochemistry, Hospices Civils de Lyon, Lyon Sud Hospital, 69495 Pierre Bénite, France.
Nutrients. 2022 Aug 23;14(17):3454. doi: 10.3390/nu14173454.
Maintenance hemodialysis induces water-soluble vitamins and trace elements losses, which is why recommendations regarding potential supplementation were provided, but mainly based on conventional hemodialysis. This study's aim was to measure the water-soluble vitamins and trace element losses during one on-line post-dilution hemodiafiltration (HDF) session. Thirty-nine patients under maintenance HDF were enrolled. We used the Theraflux sampler (Theradial Corp., Orvault, France) to analyze the full session dialysate mass transfer. Blood and dialysate samples were collected before and after one HDF session to measure B1, B2, B6, B9, B12, C vitamins, zinc, and selenium concentrations. Values significantly decreased for B1 (20.2%), B2 (13%), B6 (25.4%), B9 (32.6%), C (66.6%) and selenium (6.7%). No significant differences were found for vitamin B12 and zinc. The dialysate losses per session were 1.12 ± 0.88 mg for vitamin B1, 0.28 ± 0.30 mg for B2, 0.33 ± 0.09 mg for B6, 0.3 ± 0.18 mg for B9, 147.5 ± 145.50 mg for C and 25.75 ± 6.91 mg for zinc. Vitamin B12 and selenium were under detection values. In conclusion, during a standard 4hr-HDF session, we found important losses for vitamin B1, B6, B9, C and zinc, suggesting the need for regular monitoring of plasma levels and systematic supplementation of these compounds.
维持性血液透析会导致水溶性维生素和微量元素的丢失，因此建议进行潜在的补充，但主要基于常规血液透析。本研究旨在测量一次在线后稀释血液透析滤过（HDF）过程中水溶性维生素和微量元素的丢失。纳入 39 名接受维持性 HDF 的患者。我们使用 Theraflux 采样器（Theradial Corp.，Orvault，法国）分析整个透析液质量转移过程。在一次 HDF 治疗前后采集血液和透析液样本，以测量 B1、B2、B6、B9、B12、C 族维生素、锌和硒的浓度。B1（20.2%）、B2（13%）、B6（25.4%）、B9（32.6%）、C（66.6%）和硒（6.7%）的浓度显著降低。B12 和锌的浓度没有显著差异。每次透析治疗丢失的维生素 B1 为 1.12±0.88mg，B2 为 0.28±0.30mg，B6 为 0.33±0.09mg，B9 为 0.3±0.18mg，C 为 147.5±145.50mg，锌为 25.75±6.91mg。维生素 B12 和硒的含量低于检测值。总之，在标准的 4 小时 HDF 治疗过程中，我们发现维生素 B1、B6、B9、C 和锌有大量丢失，这提示我们需要定期监测血浆水平，并对这些化合物进行系统补充。
