3.1. Intake

2. Particularities of HD patients

• muscle cramps during dialysis

3. Status of vitamin E in HD patients

Figure 1. Oxidative stress in hemodialysis patients.

Profile of vitamin E status in these patients is as follows:

consumption is another one [1–4].

• limited intake

• not cleared by dialysis

• disturbances in lipid profile • increased cardiovascular risk

• increased oxidative stress (as displayed in Figure 1)

• increased inflammation markers and malnutrition inflammation syndrome

The level of vitamin E in HD patients is influenced by dietary intake, particularities in metabolism and clearance. The plasma level of vitamin E is usually normal, even though there are studies that found predialysis low levels of alpha-tocopherol. However, the number of patients included was small and similar results have not been identified in other larger studies. Gastrointestinal disturbances in uremic patients might lead to poor absorption and this could be an explanation for low plasma levels of vitamin E identified in some HD patients, while increased

• dietary restrictions

32 Vitamin E in Health and Disease

Usually, HD patients have sufficient daily dietary intake of vitamin E, but sources of vitamin E are limited and mainly represented by vegetable oils. Many other sources are restricted in


Table 1. Sources of vitamin E for hemodialysis patients.

these patients because of its increased phosphorus and/or potassium content. Table 1 displays vitamin E containing foods which are allowed (A), allowed with restricted portions size (ARP), or not allowed (NA) in patients undergoing chronic hemodialysis [4–6].
