Subject: B 6/pyridoxal/dialysis
Adv Perit Dial 2000;16:308-12
Vitamin B6 deficiency in elderly patients on chronic peritoneal dialysis.
Moriwaki K, Kanno Y, Nakamoto H, Okada H, Suzuki H
Department of Nephrology, Saitama Medical School, Japan.
[Medline record in process]
Polyneuropathy is one of the most frequent manifestations in chronic
uremia. Among the factors related to polyneuropathy, vitamin B6
deficiency is well known. The exact prevalence of vitamin B6
deficiency related to neurological manifestations has not been
previously reported. We studied vitamin B6 status, collected
self-reported symptoms, and carried out full neurological examinations
in 66 patients on chronic peritoneal dialysis. Vitamin B6 status was
estimated by direct measurement of pyridoxal phosphate. In general,
symptoms related to vitamin B6 deficiency are peripheral neuropathies,
such as paresthesia, burning and painful dysesthesias, and thermal
sensations. These symptoms were reported and assigned one of five
grade scores. Of our 66 patients, 12 patients complained at least one
sensory abnormality. The levels of vitamin B6 in the patients varied
between 1.0 ng/mL and 30 ng/mL. Patients who complained of
neurological symptoms owing to vitamin B6 deficiency were
significantly older than the other patients. In analyzing the
symptomatic cases before and after vitamin B6 supplementation, a
significant correlation was seen between the level of vitamin B6 and
symptoms. Within one month after initiation of oral vitamin B6
supplementations (30 mg daily), levels of pyridoxal phosphate rose,
and sensory abnormalities improved in 8 of 12 patients. When
peripheral neuropathy is suspected in elderly patients on chronic
peritoneal dialysis, vitamin B6 deficiency should be taken into
consideration as the cause. If vitamin B6 deficiency is appropriately
treated by oral supplementation, sensory abnormalities can be
eliminated.
PMID: 11045317, UI: 20500078
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