Abstract
In order to clarity the potential toxic effects of an excess of vitamin A (VA) in regular dialysis patients, plasma VA, retinol binding protein (RBP) and prealbumin (PA) were measured and the relationhsip between plasma VA levels and clinical or biochemical abnormalities was delemined in 47 regular dialysis patients.
Mean levels of VA (418±24mcg/dl), RBP (417±19mcg/ml) and PA (582±20mcg/ml) were significantly elevated. There was a significant linear negative relationship between plasma VA levels and the hematocrit (HCT) (r=-0.499). The RBP/VA ratio also was correlated with the HCT (r=0.613) and was inversely related to plasma i-PTH (r=-0.608) and very low density lipoprotein (r=-0.324). Theme was on correlation between plasma VA and serum Ca, P, or triglycerides.
These results suggest that significantly elevated plasma levels of VA can contribute to anemia in regular dialysis patients and that hypervitaminosis A is severe in patients with a low RBP/VA ratio. This suggests that the potential membranolytic effect of VA is apparent only when VA is bound to lipoprotein, not to RBP. These findings suggest that VA preparations should not be given to patients on regular dialysis treatment
