To the Editor.—
It is still common practice to supplement diets of hemodialysis patients with multivitamin preparations.1,2 Yet several reports in the literature warn about the administration of vitamin A, since considerably elevated plasma levels of this compound occur in renal failure.1-3 By analogy, it is generally assumed that no supplements of other fat-soluble vitamins, ie, vitamins E and K, are required either.3Ito and co-workers (1971;217:699) previously reported subnormal vitamin E levels in patients undergoing hemodialysis. Their findings have been interpreted as providing a basis for diet supplementation with vitamin E. Unfortunately, these authors studied only six patients and used an assay of questionable reliability.We successfully applied a previously described specific high-performance liquid chromatography method4 for the determination of serum vitamin E in maintenance hemodialysis patients. Normal levels were found before as well as after dialysis, ie, 11.3 ±5.4 μg/mL and 11.3 ±5.2 μg/mL,
De Bevere VORC, Nelis HJCF, De Leenheer AP, Lambert WE, De Paepe M, Ringoir S. Vitamin E Levels in Hemodialysis Patients. JAMA. 1982;247(17):2371. doi:10.1001/jama.1982.03320420027020
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