Functional thiamine deficiency in patients with chronic kidney disease in Northeast Thailand.

Background: Patients with chronic kidney disease (CKD) may be vulnerable to thiamine insufficiency due to dietary restrictions, altered metabolism, and renal replacement therapy. We aimed to determine the prevalence of functional thiamine deficiency, its distribution across CKD stages, and the associated clinical factors in a Thai population.

Areas covered: Thiamine status was assessed in red blood cells using the erythrocyte transketolase activity coefficient (ETKAC) assay. Participants (n = 605) were categorized as having normal thiamine status (ETKAC ≤1.25) or functional thiamine deficiency (ETKAC >1.25). The prevalence of functional thiamine deficiency was 6.1% overall and 6.4% among participants with CKD. Univariate analyses of participants with CKD showed that higher systolic blood pressure (SBP), hypertension, and lower estimated glomerular filtration rate (eGFR) were associated with functional thiamine deficiency. In the multivariable analysis adjusted for age, sex, SBP, eGFR, and alcohol intake, hypertension remained independently associated with functional thiamine deficiency (β = 2.202; 95% confidence interval (CI) for the corresponding odds ratio (OR): 2.311-35.383; p = 0.002).

Expert opinion/commentary: Functional thiamine deficiency was observed in a subset of participants, particularly in patients with CKD and hypertension, supporting further investigation of thiamine status in CKD populations.