Assessment of thiamin status in chronic renal failure patients, transplantrecipients and hemodialysis patients receiving a multivitamin supplementation

The thiamin status of patients with chronic renal failure (CRF, n = 14), di alysis patients (DP, n = 24) and patients after renal transplantation (RT, n = 19) was assessed. Thiamin intake was calculated at mean levels of 1.26 mg/d (CRF), 0.83 mg/d (DP) and 1.42, mg/d (RT). Corresponding mean plasma c oncentrations were 64.2 nmol/l (CRF), 78.3 nmol/l (DP) and 55.1 nmol.l (RT) . Thiamin supplement of 1.5 mg or 8.0 mg orally given to patients of the (D P) after each dialysis session showed slightly higher thiamin concentration in plasma. Transketolase activity coefficients (ETK-AC) were in the same r ange (1.11...1.19) except for RT-patients concentrations dropped to 75 and/ or 82% in patients supplemented with 1.5 mg or 8.0 mg. They both reached in itial levels again 44 hours later. Despite large inter-individual differenc es, thiamin concentrations increased in the non-supplemented DP-group. ETK- AC did not change after a 14-day interruption of supplementation and did no t deteriorate after a single dialysis session, both in supplemented and non -supplemented patients. A daily thiamin supplementation which complies with the RDA for healthy subjects is indicated in DP and is sufficient to indic ated in DP sufficient to keep thiamin status within the normal range.