RENAL REALITY CHECK

Have you seen this pattern in dialysis patients?

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Counselling Conundrum: "My elderly mother has a prescription for Replavite and Tums. Is that just because she has vitamin deficiencies and heart burn? That's what Google said."

Concise Conclusion: Your mother likely has problems with her kidneys and is undergoing dialysis to do the kidney's job. This process removes water-soluble vitamins like B vitamins and vitamin C, which Replavite replenishes. The Tums come in because when the kidneys aren't working properly, a mineral called phosphorus builds up in the blood, and Tums bind to it to prevent a dangerous blood build-up.

Quick Wrap-up: Remind patients to take Tums with meals. Keep in mind, though common in practice, KDIGO guidelines lean towards non-calcium binders (e.g. sevelamer) to prevent arterial calcification from hypercalcemia.

Dive Deeper

1) Demand for Water-Soluble Vitamins in a Group of Patients with CKD versus Interventions and Supplementation—A Systematic Review - PMC

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