J Med Assoc Thai 1997; 80 (11):724

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Effects of Dietary Counseling on Vitamin A, B-1, B-2 and Zinc Status of Chronic Hemodialysis Patients
Komindr S Mail, Puchaiwatananon O , Thirawitayakom J , Domrongkitchaiporn S , Songchitsomboon S

Twenty-one chronic hemodialysis patients underwent nutritional evaluation and regular
dietary counseling to improve the protein and energy intake for 8 weeks. As a result, the mean
serum potassium and phosphorus concentrations were increased but were still within the normal
ranges. After counseling, the frequency of abnormal TPPE and EGRAC were decreased (9.5 to 4.8
per cent and 19 to 14.3 per cent, respectively) while the frequency of hypervitaminosis A was
increased from 67 to 81 per cent. Though the evidence of zinc deficiency was decreased from 81
to 62 per cent after counseling, mean serum zinc levels were low in both periods and inadequate
vitamin B status cannot be totally eradicated due to the limitation of food selection. Therefore,
regular supplementation of vitamin B complex is required, whereas, vitamin A supplementation
must be prohibited in chronic HD patients. Small daily doses of potassium chelator and phosphate
binder are mandatory if improvement of nutritional status is aimed to be one of the therapeutic

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