The article and protocol are for informational purposes only, and not intended as medical advice. Please read the Medical Disclaimer below, and consult with your personal physician before starting supplements and acting upon any information on this website.

Discussion

Chronic kidney disease, or failure, requires dialysis to clean out toxic waste products that build up in the blood.  A person may be placed on hemodialysis or peritoneal dialysis. With either type of dialysis, there are special vitamin and mineral needs.

For those receiving hemodialysis generally need iron, where as a patient on peritoneal dialysis may not require supplemental iron.  Either way, iron levels, as well as other vitamin and mineral levels will be monitored by your doctor and health care professionals managing care.

There is an extra need for dialysis patients to get trace minerals, selenium, zinc, copper, etc., but not too much. It is important to not get too much vitamin A, which is why the supplements in the protocol are mostly beta carotene, which does not cause a toxic buildup of vitamin A.

Vitamin D is needed in dialysis patients, as the kidneys are important in internal vitamin D production, which is impaired in chronic kidney disease or failure.

With dialysis, it is important to limit potassium and phosphorus intake.

Having kidney failure and being on dialysis changes your need for some nutrients. Some of the reasons are:

• Waste products build up daily in your body, and change the way vitamins and minerals are utilized.
• There is excess oxidative damage and inflammation throughout the body due to the excessive waste products that build up daily, increasing the need for safe antioxidants.
• Some vitamins are lost during dialysis treatment.
• A special renal failure diet can cause a deficiency in certain vitamins and minerals.
• Kidney disease decreases your body’s ability to make certain vitamins, such as vitamin D.

Dialysis patients usually need additional protein in their diets. However, this protocol is focusing on nutritional supplementation.

Please see medical disclaimer below.

Protocol for Hemodialysis and Peritoneal Dialysis

I have included a protocol for both hemodialysis and one for peritoneal dialysis.  Of course, this must be discussed first with the health care professionals who are managing patient care prior to taking the supplements.

Minimal Protocol for Hemodialysis and Peritoneal Dialysis

Basic Protocol for Hemodialysis and Peritoneal Dialysis

Average Protocol for Hemodialysis and Peritoneal Dialysis

Advanced Protocol for Hemodialysis and Peritoneal Dialysis

• AM: With, or after breakfast
• Noon: At lunchtime with food, or shortly thereafter
• PM: Late afternoon with food, or at, or after dinner
• Please see my list of ingredients (below) that I like to see provided by a foundational vitamin and mineral supplement.
• Liver support supplement that provides numerous ingredients, including N-Acetyl-L-Cysteine (NAC), turmeric extract (curcumin), green tea extract, olive extract, broccoli extract, alpha lipoic acid, milk thistle extract, and biotin.
• Beta Glucans, derived from the Shiitake and Reishi mushrooms and baker’s yeast extract.
• Vision Support formula, with lutein, zeaxanthin, bilberry extract, and zinc.
• Bacopa extract brain and memory support supplement, that also provides Coffee Cherry Extract and American Ginseng.
• Ultra Lipoic Acid can be purchased from Douglas Labs by first creating a customer account by CLICKING HERE.  (If this link does not work for you, simply type “douglaslabs.com/patient-account” into a new browser tab.) Please use Referral Code 2074214. After establishing a customer account with them, you can then search their website for products by name.

Ingredients that I like to see provided collectively by vitamin-antioxidant & chelated mineral tablets

Vitamin A, mostly as Beta Carotene
Vitamin C
Vitamin D3
Vitamin E
Vitamin K (K1 & K2)
B-Complex Vitamins
Curcumin (turmeric extract)
Quercetin
Green Tea Extract
Olive Extract
Rutin
Resveratrol
Choline
Lutein
Lycopene
N-Acetyl-L-Cysteine (NAC)
Calcium
Magnesium
Iodine (as potassium iodide)
Zinc
Selenium
Copper
Manganese
Chromium
Molybdenum
Including Ultra Trace Minerals

Medical Disclaimer

Information on this website, written, spoken, or in any other communication by Dr. Ladd McNamara or any other information or reference is for informational purposes only. The information provided on this website is a result of years of practice, experience, and study by the author. This information is not intended as a substitute for the advice provided by someone’s personal licensed physician or other healthcare professional, or any information contained on or in any product label or packaging. Do not use the information on this website, or any other form of communication from Dr. Ladd McNamara or the Dr. Ladd VIP Program, for diagnosing or treatment of a health issue or disease, or for the prescribing of medication or the use of supplementation without a discussion with your licensed health professional first.  At best, the information provided on this website is only meant to supplement information provided by your own doctor or health professional, not to replace medical advice.  The information from this website is not meant to cover all possible uses, precautions, interactions or possible adverse effects of nutritional supplements with or without medications, or in conjunction with specific medical conditions.  The information from this website may not fit your specific health circumstances.  Never delay seeking medical care or disregard advise from your health care professional because of information you have received directly or indirectly from this website, from the Dr. Ladd VIP Program, or from Dr. Ladd McNamara himself.   Always speak with your physician or other healthcare professional before making any changes to your medication or embarking on a nutritional, herbal or homeopathic supplement program, or before using any treatment for a health concern.  If you have, or suspect that you have, a medical problem, contact your health care provider promptly.  Do not disregard professional medical advice or delay in seeking professional advice because of something you have read or heard on this website, or due to any other information from Dr. Ladd McNamara or his representatives. Information provided on this website or the V.I.P. Program, and the use of any products or services mentioned on this website (or as a result of information provided this program, article, or website) by you DOES NOT create a doctor-patient relationship between you and Ladd McNamara, M.D.  Information and statements regarding dietary supplements have not been evaluated by the Food and Drug Administration and are not intended to diagnose, treat, cure, or prevent any disease.

References

1. Bahn I, et al.  Nutritional vitamin D supplementation in dialysis: a randomized trial.  Clin J Am Soc Nephrol. 2015 Apr 7;10(4):611-9.
2. Mansour AG, et al.  Vitamin K2 supplementation and arterial stiffness among renal transplant recipients-a single-arm, single-center clinical trial.  J Am Soc Hypertens. 2017 Sep;11(9):589-597.
3. Sultana T, et al.  Oral vitamin C supplementation reduces erythropoietin requirement in hemodialysis patients with functional iron deficiency.  Int Urol Nephrol. 2016 Sep;48(9):1519-24.
4. Apetrii M, et al.  Magnesium supplementation: A consideration in dialysis patients.  Semin Dial. 2018 Jan;31(1):11-14.
5. Chazot C, et al.  Can Outcomes be Improved in Dialysis Patients by Optimizing Trace Mineral, Micronutrient, and Antioxidant Status?: The Impact of Vitamins and their Supplementation.  Semin Dial. Jan-Feb 2016;29(1):39-48.

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