Anaemia is a major comorbidity in people with end stage renal disease (ESRD) and often dependent on blood transfusions and erythropoietin stimulating agents (ESA), for management of anaemia. ESA effectively increase haemoglobin and improve quality of life in patients on dialysis but adds up enormous cost burden.
ESA takes care of the deficiency of Erythropoietin production, while there are other factors like inflammation, iron deficiency, chronic infections, bone marrow failure, and hyperparathyroidism which can also contribute to anaemia. B12 is also a known factor which leads to anaemia, commonly known as megaloblastic anaemia.
A recent study says Vitamin B12 supplementation was associated with a decrease in the mean dose of ESA administration while maintaining a stable haemoglobin level. Maintaining serum vitamin B12 levels improves functionality and may allow a decrease in the use of ESA’s, avoiding their toxicities and significant costs.
The factors predisposing to B12 deficiency are-
- Poor nutritional intake
- Limitation of various food groups due to high electrolyte content.
- High clearance through use of modern high flux dialyzers
- Poor stomach enzymes activity
- Lack of intrinsic factor require for absorption of B12
Symptoms of B12 deficiency
- Fatigue, weakness, constipation, loss of appetite, and weight loss
- Neurological changes, such as numbness and tingling in the hands and feet, can also occur.
- Other symptoms may include poor memory, and soreness of the mouth or tongue
Food Sources of B12
Vitamin B12 is naturally found in animal products, including fish, meat, poultry, eggs, milk, and milk products. Strict vegetarians and vegans are at greater risk than lacto-ovo vegetarians of developing vitamin B12 deficiency as natural food sources of vitamin B12 are limited to animal foods.
Vitamin B12 is generally not present in plant foods, but fortified breakfast cereals are a readily available source of vitamin B12 with high bioavailability for vegetarians.. Fortified foods vary in formulation, so it is important to read the Nutrition Facts labels on food products to determine the types and amounts of added nutrients they contain.
The recommended dietary allowance for Indians for B12 is 1 mcg per day. B 12 is a water soluble vitamin and is generally considered safe even at as high doses as body excretes excess through urine.
Fortified nutritional yeast contains high amounts of vitamin B12 and can be used to help prevent deficiency in vegans. It can be added as a savoury seasoning to a variety of dishes, including pasta, vegetables, and salads. Follow the link https://www.nephroplus.com/recipes/nooch-popcorn/ for more kidney friendly recipe.
Composition of Nutritional yeast fortified vitamin B12
|Fortified Nutritional Yeast Flakes|
|Amount||2 tbsp/ 9 g|
|B 12 mcg||14|