Last Updated: August 26, 2025
Medically reviewed by NKF Patient Education Team
About vitamins in chronic kidney disease
Most of the vitamins your body needs come from the food and drinks you have each day. Your body cannot make them on its own. Eating different kinds of foods – like fruits, vegetables, grains, dairy, and proteins (including animal proteins and plant-based proteins) - helps give your body the right mix of vitamins.
If you have chronic kidney disease (CKD), your body might not be able to get all the vitamins it needs in the right amounts. This can happen for several reasons:
- Your kidneys help control the balance of vitamins in your body. With CKD, some vitamins may build up too much, and others may be lost too easily.
- If you have low appetite or your healthcare team has recommended lowering how much protein, potassium, and/or phosphorus you eat, you may not be getting enough vitamins.
- Waste products that build up in your body with CKD can make it harder for your body to use vitamins the right way.
- If you are on dialysis, some vitamins are lost during each treatment.
- If you have received a kidney transplant, your immunosuppressants (anti-rejection medicines) can affect vitamin levels in your body.
So, your healthcare team will review your diet to make sure you are getting the right amount and types of vitamins. Depending on your specific needs, they may recommend taking vitamin supplements (pills or drinks) to help your body stay healthy.
How they work
Vitamins are small nutrients your body needs every day to stay healthy. Many people get enough vitamins from food. But for some people with CKD, a healthy diet may not be enough. So, your healthcare professional may recommend vitamin supplements to help replace what your body is missing.
Your healthcare professional and kidney dietitian can recommend which vitamins you may need based on your health history and blood tests.
Types
Your healthcare professional may recommend one or more of the following vitamins for you depending on your health and other factors:
- B vitamins (B-complex): These usually come in one pill but can also be taken separately. Each B vitamin has a different job. For example:
- B9 (folic acid) and B12 (cobalamin) help your body make red blood cells and treat anemia (low red blood cells), usually in addition to iron supplements.
- B1 (thiamine), B2 (riboflavin), B3 (niacin), B5 (pantothenic acid), B6 (pyridoxine), and B7 (biotin) help turn food into energy and keep your nerves and tissues healthy.
- Vitamin C: helps your immune system fight infections and helps cuts and bruises heal.
- Vitamin D: helps your body absorb (take in) calcium to keep your bones strong.
- Your kidneys help “turn on” vitamin D. If you have stage 4 or stage 5 CKD, your kidneys may not do this well. If this happens, your healthcare professional may prescribe a special form of vitamin D (available as a pill taken daily or an injection that can be given with dialysis).
Some products with a mix of vitamin C and important B vitamins designed for people living with CKD are available with a prescription. Examples include: Nephrocaps, Nephro-Vite, Nephronex, NephplexRx, Renal Caps, Rena-Vite, or Kidney-Vite.
Effectiveness
It can be hard to tell if vitamins are working. It depends on which ones you take and why you are taking them - some people take vitamins to treat a health problem while others are preventing a problem before it starts. One way to know if a vitamin is helping is by how you feel. For example, you might notice more energy or less nerve pain (with the B vitamins) or faster healing from cuts (for vitamin C).
Sometimes your healthcare professional will do blood tests to check your vitamin levels. This is more common for vitamin D and folic acid (vitamin B9). If you take vitamins for anemia (low red blood cells), you may need extra blood tests too.
If you take vitamin D, try to take it with food. This helps your body absorb (take in) more of it.
Safety
For B vitamins and vitamin C, your body uses what it needs and gets rid of the rest through your kidneys. But with CKD, your kidneys may not be able to remove the extra amount. This can make them build up and cause problems. For example, too much vitamin C can raise your risk of kidney stones, specifically calcium oxalate stones.
Vitamins A, E, and K usually don’t need to be taken as supplements if you have CKD. Most people get enough of these vitamins in their diet, even with CKD. Also, your body stores these vitamins to use later. So, taking too much can cause a buildup in your body and be harmful.
Vitamins are medicines too! Only take the ones your healthcare professional recommends (and at the doses recommended). Don’t start or stop any vitamin on your own - always talk with your healthcare team first.
Questions for your healthcare team
- Do I need to take any vitamins?
- Not everyone with CKD needs vitamin supplements. Talk with your healthcare team to get information that is tailored to your needs.
- How can I get more vitamins from my diet?
- Your diet is your main source of vitamins, with supplements used to fill in any gaps. Work with a kidney dietitian to find vitamin-rich foods that you enjoy and fit into your CKD diet.
- How will I know if my vitamin levels are too low or too high?
- Not all vitamin levels can be easily measured with a blood test. Talk with your healthcare team about how to check if the dose of each vitamin is right for you.
- Are there any vitamins I should avoid?
- In rare cases, people may be very sensitive to some vitamins. For example, people who have a history of calcium oxalate stones may need to take low doses or avoid vitamin C. So, talk with your healthcare professional to see if there are any vitamins you may need to avoid based on your health history and risk factors.
- Can I take “over the counter” vitamins, or do I need a prescription version?
- Most vitamins are available “over the counter” or OTC, which means you can buy them without a prescription. For many people, OTC vitamins are usually appropriate. But sometimes, a prescription version may be more appropriate for you, Examples include activated vitamin D, or a multivitamin designed for people with kidney disease.
- Should I be taking a multivitamin?
- While taking a daily multivitamin is generally considered safe for most people, sometimes it can cause harm. Also, just because one vitamin level might be low, doesn’t mean they all are. Lastly, the doses of individual vitamins in a multivitamin product may not be enough to meet your health needs. So, talk with your healthcare team about which approach is better for you – a multivitamin or separate vitamin products.
