Abstract: SA-PO155

Thiamine Deficiency in End-Stage CKD Patients

Session Information

Category: Nutrition, Inflammation, and Metabolism

  • 1401 Nutrition, Inflammation, Metabolism

Authors

  • Saka, Yosuke, Kasugai Municipal Hospital, Kasugai, AIchi, Japan
  • Naruse, Tomohiko, Kasugai Municipal Hospital, Kasugai, AIchi, Japan
Background

Thiamine deficiency presents with several clinical manifestations such as heart failure, peripheral neuropathy and encephalopathy. Thiamine deficiency is observed also in patients with chronic kidney disease (CKD), resulting from malnutrition and long-term diuretic therapy. The risk of thiamine deficiency might be enhanced, especially in end-stage CKD patients. Thereby, we assessed thiamine status on incident dialysis patients.

Methods

This study included 188 consecutive patients initiated into dialysis between April 2013 and March 2016 in our hospital. Of 188 patients, 14 patients taking thiamine supplements were excluded. Thiamine status was evaluated by high-performance liquid chromatography (HPLC) measurement of thiamine in whole blood. We evaluated the association between blood thiamine concentration and other clinical parameters.

Results

The median value of blood thiamine concentration was 29.7 ng/mL [IQR:24.4-38.8]. In 21 patients (12.1%), blood thiamine concentration was lower than the normal lower limit (21.3 ng/ml). In Spearman univariate correlation analysis, blood thiamine concentration was correlated with age, Barthel index (BI) score and body mass index (BMI). Serum albumin concentration and loop diuretics therapy had no correlation with blood thiamine concentration. Multivariate regression analysis indicated that age (β-coefficient = −0.24, p = 0.043) and BI score (β-coefficient = 0.14, p = 0.025) were independent risk factors of thiamine deficiency.

Conclusion

This study shows that the proportion of end-stage CKD patients with low blood thiamine concentration was high. In addition, this study suggest that age and low physical activity (low score on BI) are independent risk factors of thiamine deficiency. Clinicians should be aware of thiamine deficiency when end-stage CKD patients, especially elderly patients with low physical activity, present unexplained cardiac or neurologic symptoms.