Vitamin B12 deficiency in dialysis patients: risk factors, diagnosis, complications, and treatment: A comprehensive review

Abstract

Vitamin B12 deficiency is a significant concern among patients with end-stage renal disease undergoing dialysis. However, there hasn’t been extensive research conducted on this particular patient group. The reported incidence rates vary widely, ranging from 20% to 90%, reflecting the complexity of its diagnosis. Dialysis patients often face multiple nutritional deficiencies, including a lack of essential vitamins, due to factors such as dietary restrictions, impaired absorption, and nutrient loss during dialysis. Diagnosing vitamin B12 deficiency in these patients is challenging, and addressing it is crucial to prevent complications and improve their overall quality of life. This review paper delves into the available body of evidence on vitamin B12 deficiency in dialysis patients, examining the contributing risk factors, diagnostic challenges, potential complications, and available treatment options. It provides a well-rounded perspective on the topic, making it a valuable resource for researchers, healthcare practitioners, and policymakers interested in addressing the nutritional needs of dialysis patients.

Keywords: Vitamin B12 deficiency; Dialysis; Risk factors; Diagnostic challenges; Complications; Treatment

Core Tip: This review highlights the critical yet often overlooked issue of vitamin B12 deficiency in dialysis patients, emphasizing its complex diagnosis and severe complications such as anemia, neuropathy, and cardiovascular risk. The review advocates for a proactive approach in diagnosing and managing vitamin B12 deficiency, recommending comprehensive assessments beyond standard serum levels and highlighting the efficacy of high-dose oral and parenteral supplementation. These insights underscore the necessity for heightened awareness and targeted interventions to improve patient outcomes in this vulnerable population.