Vitamins and Supplements

[Starcatty]

I would like to know which vitamins and supplements are good for the kidney.

Anyone know? I have stage 3 B.

[AndrewT]

Dear Starcatty,

If you are on Dialysis, which you might well be soon -Sorry! then you are Prescribed a Multi Vitamin mixture, which replaces any vitamins 'lost' during the Dialysis. However, other than that, I would be VERY careful with taking any Supplements, without your OWN Doctors 'say so'. (Yes you have 'met' others, who do this.... or 'read Somewhere' it's Good for you... or it was Recommended by a friend..... or- need I go on?) Everyone is Different, sometimes- often?- Very Much so.

By all means 'Speak' to your Doctors/ Consultants, Covid notwithstanding, and ask for their advice. Do have any Blood, or indeed, any other Tests they recommend then be guided by them.

Please DO 'Feel Free' to ask, any of us, for further Help Starrcatty.

Very best wishes

AndrewT

[userotc in reply to AndrewT]

Do you have any reputable evidence of negative kidney effects with any supplements to share?

Medics are indeed generally cautious but no evidence generally supplied. We were cautious about magnesium for mum due to apparent concern about kidney stones online. But I can share documents from reputable kidney organisations eg NKF, that state non-harming. So she is on a very low dose as magnesium is good.

[Starcatty in reply to userotc]

No I have no evidence of any side effects as i haven't looked for any.......I don't have a nephrologist so I have no one to ask.

[userotc in reply to Starcatty]

Thanks but my question was for Andrew.

[AndrewT in reply to userotc]

Sorry I didn't realise this question was for Me, sorry. I don't have any 'Concrete' evidence, only 'Anecdotal'- but from a Number Places.... not least my 'Own' Medical Team.

AndrewT

[userotc in reply to AndrewT]

I understand why medics may be wary/negative about supplements but I put that down to technical ignorance as I understand their training generally includes ~1 day of supplementation compared to years for drugs. And potential contraindications between the two (which there are) makes drug advice trickier.

But research is likely to dispel most or all myths that supplements harm kidneys eg this for magnesium which states it does not damage the kidney directly kidney.org/blog/ask-doctor/...

Being diplomatic, Ive not suggested any financial incentives for medics to degrade supplements in favour of drugs nor adverse effects of drugs eg NSAIDs, on kidneys!.

[Starcatty in reply to AndrewT]

Thank you for your support Andrew.

[Starcatty in reply to AndrewT]

Thank you for your support Andrew.

[Sophiebun11 in reply to AndrewT]

I'm curious to know why you'd think someone at Stage 3B would be on dialysis or say they might well be on dialysis soon??????

I haven't heard of anyone at Stage 3B being on dialysis. I didn't think that way when I got to Stage 4. Even some in Stage 5 don't have dialysis yet.

Am I missing something?

[userotc]

I disagree with Andrew. You can stave off dialysis etc by managing your CKD, largely via diet and well-being.

If only considering eGFR, my mum has essentially improved her level from stage 3b to 2 since a nephrectomy 4.5y ago. No-one has confirmed the latter stage and her accelerating proteinuria may preclude it but we are working on that, again naturally.

Re supplements, I agree that medics will be very cautious as they have with mum. But the same, cautious/non-commital nephrologist has also not helped her with the proteinuria. He just wants to take credit for her eGFR progress for some, unknown reason. You may receive other suggestions on here but it's best you do your own research or enlist naturopathic support.

Mum is trying cordyceps but it's too early to report an effect. She also takes supplements for other reasons eg vit D and menopause ones.

[WYOAnne NKF Ambassador]

Always get your nephrologist OK before taking any supplements, vitamins, etc. We are all different. It will depend on your labs also

[drmind]

My nephrologist has been titrating some supplements for me and has my labs within normal range. I take:

Vitamin D3 -50 mcg daily

Calcitriol - 0.25 m g : initially 1 daily, then 5x weekly, and currently 3x weekly

Magnesium - 500 mg : initially 1 daily, then 250 mg daily, now discontinued

These supplements have put my Vitamin D, calcium, and magnesium all in the normal range. Last year with another kidney doctor I had hyperparathroid and he did nothing about it! Current kidney doctor fixed it. Hes a blessing to have.

Note on Magnesium: this did upset my digestive tract so I cut it down myself and also discontinued it. Lab results show level in low normal range. Will see my nephrologist in two weeks and will discuss it with him.

Hope this helps.

[Starcatty in reply to drmind]

Yes thank you........your reply was very helpful.

[Hidden]

Vitamin D3 -50 mcg daily is = to 2000 IU in standard measurement

[Sophiebun11]

I take Vit D and Calcium which are prescribed by my Neph as well as B12 which I'm low in.

Have your Vit D tested on blood work, if you PTH is elevated it's important to take Vit D with CKD or in general.

[whats]

Coenzyme Q is safe in CKD: pubmed.ncbi.nlm.nih.gov/304...

From the article:

Conclusion: Overall, the current meta-analysis demonstrated that CoQ10 supplementation significantly improved metabolic profile in patients with CKD by reducing total cholesterol, LDL-cholesterol, MDA and creatinine levels, yet it did not affect fasting glucose, insulin, HOMA-IR, and CRP concentration.

Creatine levels are the primary determinant of GFR if you didn't know.

I also take a multi-vitamin (doctor recommended) and a few other things, but I'm not sure how safe they are.

[Skeptix in reply to whats]

Is it known what the mechanism of creatinine reduction is? eGFR is based on creatinine alright, but if the reduction obtained by CO-q10 isn't through improved kidney filtering then what? We are not so much interested in eGFR as we are GFR.

I wonder whether CO-q10 levels drop on a plant diet - I see sources are red meat. But also that the body makes it.

Is it a question of getting levels checked first to see whether there's a need to supplement?

[whats in reply to Skeptix]

I just take a supplement. Don't even know how my dose compare to the study dose. Its pretty, red and smooth and smallish. There's more detail in the PubMed article. I've been trying to research supplements more- I just found out that Calcium is the trickiest one in CKD especially for women after menopause who are more inclined to osteoporosis. CKD interferes with calcium metabolism at early stage 3. If you're getting less than 800Mg a day, you are probably absorbing it from bone (men & women). If you get more than 1000mg/day, you're at risk of soft-tissue calcium deposits, but there's no simple test. ncbi.nlm.nih.gov/pmc/articl... Vitamin D supplements seem generally good and important (levels are easy to measure in a blood test), vitamin A supplements bad. This is what I've learned so far.

[Skeptix in reply to whats]

Interesting paper. What I've to figure / ask the docs is whether calcium level / balance can be somewhat determined from blood markers? It would appear that things like FGF 23, 1.25 vit d etc ought to 'look' a certain way (its not just a matter of measuring serum calcium).

A bit like reading tea leaves!

But this paper outlines the extreme difficulty in establishing calcium balance (I.e. not too little (bone problems) vs not too much (vascular calcification) in even a clinical/research setting!!!

It would seem that calcium intake is impossible for home/lay assessment given the difficulty of knowing precisely what's in food/supplements. See this remark in the paper you linked as to carrying out a calcium intake assessment:

"Nutrient databases provide the starting point for designing any controlled diet, but it is important to note they are fraught with error, and pre-study composite meals must be chemically analyzed for nutrient content, and adjustments made to reach target values".

It's all very well saying to aim for 1000mg. But how does one know one is getting 1000mg?!!! Leave aside the unknowable intake from any processed food (which typically doesn't include a calcium declaration). But even naked food declarations will vary ("fraught with error" says this paper). And it's true - depending on which food database you use, you'll get different values. How much would depend on the quality of the food and whether (say in the case of plant) whether it was grown on mineral depletes soil??

Before we supplement, the question 'should we supplement'?

[Starcatty in reply to Skeptix]

good reply. It's all very iffy and confusing.

[whats in reply to Skeptix]

Since many kidney patients give up dairy, and since our excretion of nutrients is increasingly abnormal, it may be smart to take a little supplemental calcium, like 400 or 500 mg along with Vitamin D. If you excrete less calcium as your kidneys get weaker, I wonder why tests for urinary calcium aren't recommended. I guess you'd still have to assess calcium intake to compare with excretion. Other factors, like taking prednisone (as I do) also increase bone reabsorption. My lupus Dr. prescribed 1-2G of calcium per day back when my kidney function was near normal. A bone scan (which the lupus doc orders every decade or so) will tell you if you're bones are dense enough. This is more commonly done for women since we are more prone to osteoporosis. Cardiologists may be able to tell just by listening or by watching blood vessels move on a scan the likelihood of calcification.