High-flux hemodialysis does not increase vitamin B loss compared with low-flux hemodialysis.

OBJECTIVE: A consistent effect of hemodialysis (HD) on vitamin B loss has not been fully demonstrated, and the effect of high-flux hemodialysis (HFHD) is also inconclusive. The aim of this study was to identify the loss of vitamin B1, B3, B5, and B6 in a single HD session, and to evaluate the effect of HFHD on vitamin B removal.

METHODS: Patients on maintenance HD were enrolled in this study. They were divided into low-flux hemodialysis (LFHD) group and high-flux hemodialysis (HFHD) group. Vitamin B1, B3, B5, and B6 (pyridoxal 5'-phosphate, PLP) concentrations in blood pre- and post- a HD session, as well as in the spent dialysate were measured. Loss of vitamin B was calculated, and the difference in vitamin B loss between the two groups was compared. The association between HFHD and vitamin B loss was estimated using multivariable linear regression analysis.

RESULTS: Seventy-six patients were included, of whom 29 were on LFHD and 47 were on HFHD. The median reduction ratio (RR) of serum vitamin B1, B3, B5, and B6 after a single HD session was 38.1%, 24.9%, 48.4%, and 44.7%, respectively. The median concentration of vitamin B1, B3, B5, and B6 in the dialysate was 0.3μg/l, 2.9μg/ml, 2.0 μg/l, and 0.4ng/ml. There was no difference in either the RR of vitamin B in blood, or the concentration in dialysate between LFHD and HFHD group. After adjusting for covariates by multivariable regression, HFHD had no effect on vitamin B1, B3, B5, or B6 removal.

CONCLUSION: Vitamin B1, B3, B5, and B6 can be removed by HD, and HFHD does not increase the loss.