ESPN 50th Annual Meeting

ESPN 2017


 
Vitamin B6 concentrations in paediatric dialysis patients
TRIONA JOYCE 1 FRANCES COURT BROWN 1 CHRISTOPHER JD REID 1 MANISH D SINHA 1

1- EVELINA LONDON CHILDRENS HOSPITAL
 
Introduction:

Studies in adult dialysis patients have shown vitamin B6 deficiency is common. Vitamin B6 levels are not routinely tested in paediatric dialysis patients and recent data is lacking in this patient group.  K/DOQI guidelines recommend that children with CKD on dialysis receive a water-soluble vitamin supplement.  This study investigated vitamin B6 concentrations in our paediatric dialysis patients.  

Material and methods:

Retrospective review, including all children on maintenance dialysis (peritoneal dialysis, PD; home haemodialysis, HHD; intermittent haemodialysis, IHD), for vitamin B6 concentrations over a recent 24 month period.

Results:

18 children (8 HD, 7 PD, 3 HHD) with mean±SD age 8.4±6.3 years (15 boys).  There were 14 white British, 3 Black and 1 Asian ethnicity.  Vitamin B6 concentrations were within range (35.2-110.1nmol/L) in 44% with the remainder above normal range (130-404.1nmol/L).  Eleven children were receiving enteral feeds, 8 had high vitamin B6 levels of which 6 were feed dependent (feeds provided 0.08-1.04mg vitamin B6/d) (40-148% DRV).  Half of these children were meeting their DRV for vitamin B6 from feeds alone.  Four of the feed dependent children received a supplement containing vitamin B6 (1-11mg vitamin B6/d) (1-12 times the DRV).  Seven children were not tube fed, 2 had high vitamin B6 levels, 1 was receiving a supplement containing vitamin B6 (0.25mg daily; 21% DRV). 

Conclusions:

Children in our dialysis group, who were not receiving a tube feed had normal/high vitamin B6.  The need for supplementation in children who are tube feed dependent needs to be reviewed as this is contributing to high vitamin B6 levels.  Half of these children were already meeting their DRV for vitamin B6 from feed alone.  Routine vitamin B6 supplementation is currently not indicated in our paediatric dialysis patients.