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.