▲If kidney patients have symptoms such as fatigue, loss of appetite and muscle soreness, they should be careful about lack of vitamin D3; the picture is a situational photo, and the people in the picture have nothing to do with this article. (Photo provided / Lin Xuanren)
Sentence: Kento Hayashi
76-year-old Uncle Xie from Taichung has high blood pressure and chronic kidney disease. He is usually full of energy when he sees a doctor. However, he often complains that “the whole body is soft and weak” when he visits the doctor recently. He can’t even go out to buy breakfast. After inspection, it was found that the calcium and phosphorus deficiency was caused by vitamin D3 deficiency. After supplementing inactive vitamin D3 and moderately outdoors in the sun, it improved a lot. He said with a smile, “It’s alive again!”
▲The doctor reminds you to go out in the sun in moderation and supplement vitamin D3; the picture is a situational photo, and the patient in the picture has nothing to do with this article. (Photo provided / Lin Xuanren)
Chronic kidney disease prone to vitamin D deficiency
Uncle Xie was weak when he walked into the clinic, complaining that “I feel weak in my muscles recently” and “I feel tired after walking a few steps”. Compared with the energetic appearance in the past, he was very worried about whether the kidney function was worsening. A blood test showed that the calcium and phosphorus in the blood were low, the parathyroid gland was slightly elevated, and the ultra-low 25-(OH)-D3 was only 5ng/mL (normally greater than 30). When asked, the uncle said that the epidemic factor did not dare to Going out and restricting diet due to his kidney disease, resulting in a lack of vitamin D in the body.
Cholecalciferol, which is produced by dietary intake or sunlight exposure, is produced in the liver to 25-(OH)-D3, followed by the kidneys to produce 1,25-(OH)2-D3, and 1,25-(OH)2- D3 is commonly known as active vitamin D, which can act on the small intestine, kidneys, and bones to increase the concentration of calcium and phosphorus in the body.
Supplement with inactive vitamin D3 and sun for 15 minutes a day
Vitamin D3 deficiency is difficult to find directly, and it is often diagnosed by finding that calcium and phosphorus are low and parathyroidism is not hyperactive, and then checking 25-(OH)-D3 to find that it is too low. Most people with a normal diet are unlikely to have vitamin D deficiency, but people such as the elderly, obese, or people with insufficient sunlight are more likely to have it.
The other is patients with kidney disease. Due to kidney disease, the diet must limit the intake of protein and phosphorus. If you are like Uncle Xie and stay at home and have almost no sunshine, you will often cause endogenous vitamin D3 deficiency, resulting in fatigue and appetite. Weakness, muscle soreness and other symptoms, severe cases will also appear weakness, muscle cramps, depression, nausea and other symptoms.
It is usually recommended that patients take more vitamin D3, such as fish, milk, eggs, or 10-15 minutes of sun exposure every day. For patients with symptoms like Schieber, it is recommended to eat nutritionally inactive vitamin D3. It is recommended for adults to supplement 400-2000 IU (international unit) a day, but after supplementation, you must continue to seek medical examination.
(The author is the director of the peritoneal dialysis room of the Affiliated Hospital of Asia University)
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