Aim: (1) To describe the whole blood content of thiamine diphosphate (TDP), a biologically active form of vitamin B1 in end-stage kidney disease patients treated with hemodialysis (HD); (2) to establish the impact of a single HD procedure on TDP blood concentrations; and (3) to describe potential explanatory variables influencing TDP dialysis related losses, including dialysis prescription, vitamin B1 dietary intake and supplementation. Methods: Single-center, cross-sectional study in 50 clinically stable maintenance HD patients. The assessment of whole blood TDP with the High Performance Liquid Chromatography method, before and after a single, middle-week dialysis session and analysis of clinical and laboratory parameters potentially influencing TDP status Results: We report a significant difference in TDP levels before and after HD sessions - 42.5 (95% CI 38.7-46.2) μg/L and 23.6 (95% CI 18.9-28.2) μg/L, respectively (p = 0.000). The magnitude of intradialytic TDP changes is highly variable among individuals and is negatively associated only with the body weight of the patients (p < 0.013). Vitamin B1 dietary intake and supplementation do not influence whole blood TDP and dialysis-related loss of TDP. Conclusions: TDP, a bioactive compound of vitamin B1, is substantially lost during the HD procedure, and the magnitude of its loss is associated with the patient's body weight but it is not influenced by vitamin B1 dietary intake and standard supplementation dose.

Keywords:
Thiamine, Hemodialysis, Kidney, Nutrition, Supplementation
1.
Clase CM, Ki V, Holden RM: Water-soluble vitamins in people with low glomerular filtration rate or on dialysis: a review. Semin Dial 2013;26:546-567.
2.
Bossola M, Di Stasio E, Viola A, Leo A, Carlomagno G, Monteburini T, Cenerelli S, Santarelli S, Boggi R, Miggiano G, Vulpio C, Mele C, Tazza L: Dietary intake of trace elements, minerals, and vitamins of patients on chronic hemodialysis. Int Urol Nephrol 2014;46:809-815.
3.
Jankowska M, Szupryczyńska N, Dębska-Ślizień A, Borek P, Kaczkan M, Rutkowski B, Małgorzewicz S: Dietary intake of vitamins in different options of treatment in chronic kidney disease: is there a deficiency? Transplant Proc 2016;48:1427-1430.
4.
Bukhari FJ, Moradi H, Gollapudi P, Ju Kim H, Vaziri ND, Said HM: Effect of chronic kidney disease on the expression of thiamin and folic acid transporters. Nephrol Dial Transplant 2011;26:2137-2144.
5.
Zhang F, Masania J, Anwar A, Xue M, Zehnder D, Kanji H, Rabbani N, Thornalley PJ: The uremic toxin oxythiamine causes functional thiamine deficiency in end-stage renal disease by inhibiting transketolase activity. Kidney Int 2016;90:396-403.
6.
Sirover WD, Liu Y, Logan A, Hunter K, Benz RL, Prasad D, Avila J, Venkatchalam T, Weisberg LS, Handelman GJ: Plasma ascorbic acid concentrations in prevalent patients with end-stage renal disease on hemodialysis. J Ren Nutr 2015;25:292-300.
7.
Ebels EJ: Underlying illness in Wernicke's encephalopathy. Analysis of possible causes of under-diagnosis. Eur Neurol 1974;12:226-228.
8.
Ihara M, Ito T, Yanagihara C, Nishimura Y: Wernicke's encephalopathy associated with hemodialysis: report of two cases and review of the literature. Clin Neurol Neurosurg 1999;101:118-121.
9.
Jagadha V, Deck JH, Halliday WC, Smyth HS: Wernicke's encephalopathy in patients on peritoneal dialysis or hemodialysis. Ann Neurol 1987;21:78-84.
10.
Barbara PG, Manuel B, Elisabetta M, Giorgio S, Fabio T, Valentina C, Emanuela M, Massimo B, Giuseppe S, Paolo SG: The suddenly speechless florist on chronic dialysis: the unexpected threats of a flower shop? Diagnosis: dialysis related Wernicke encephalopathy. Nephrol Dial Transplant 2006;21:223-225.
11.
Hung SC, Hung SH, Tarng DC, Yang WC, Chen TW, Huang TP: Thiamine deficiency and unexplained encephalopathy in hemodialysis and peritoneal dialysis patients. Am J Kidney Dis 2001;38:941-947.
12.
Jarosz M: Normyżywienia dla populacji polskiej - nowelizacja. Warszawa, Instytut Żywności i Żywienia, 2012.
13.
Fouque D, Vennegoor M, ter Wee P, Wanner C, Basci A, Canaud B, Haage P, Konner K, Kooman J, Martin-Malo A, Pedrini L, Pizzarelli F, Tattersall J, Tordoir J, Vanholder R: EBPG guideline on nutrition. Nephrol Dial Transplant 2007;22(suppl 2):ii45-ii87.
14.
Frank T, Czeche K, Bitsch R, Stein G: Assessment of thiamin status in chronic renal failure patients, transplant recipients and hemodialysis patients receiving a multivitamin supplementation. Int J Vitam Nutr Res 2000;70:159-166.
15.
Ramirez G, Chen M, Boyce HW, Fuller SM, Butcher DE, Brueggemeyer CD, Newton JL: The plasma and red cell vitamin B levels of chronic hemodialysis patients: a longitudinal study. Nephron 1986;42:41-46.
16.
Heinz J, Domröse U, Westphal S, Luley C, Neumann KH, Dierkes J: Washout of water-soluble vitamins and of homocysteine during haemodialysis: effect of high-flux and low-flux dialyser membranes. Nephrology (Carlton) 2008;13:384-389.
17.
Ubukata M, Amemiya N, Nitta K, Takei T: Serum thiamine values in end-stage renal disease patients under maintenance hemodialysis. Int J Vitam Nutr Res 2016:1-8.
18.
Weber W, Kewitz H: Determination of thiamine in human plasma and its pharmacokinetics. Eur J Clin Pharmacol 1985;28:213-219.
19.
Talwar D, Davidson H, Cooney J, St JOʼReilly D: Vitamin B(1) status assessed by direct measurement of thiamin pyrophosphate in erythrocytes or whole blood by HPLC: comparison with erythrocyte transketolase activation assay. Clin Chem 2000;46:704-710.
20.
Descombes E, Boulat O, Perriard F, Fellay G: Water-soluble vitamin levels in patients undergoing high-flux hemodialysis and receiving long-term oral postdialysis vitamin supplementation. Artif Organs 2000;24:773-778.
21.
Coveney N, Polkinghorne KR, Linehan L, Corradini A, Kerr PG: Water-soluble vitamin levels in extended hours hemodialysis. Hemodial Int 2011;15:30-38.
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2017
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