How does chronic kidney disease (CKD) affect vitamin B12 and folate levels?

Chronic kidney disease (CKD) can significantly impact vitamin B12 and folate levels due to alterations in absorption, metabolism, and excretion processes. As the disease progresses, the kidneys are less able to effectively filter waste products and manage various nutrient levels, which can lead to deficiencies.

In the case of vitamin B12, patients with CKD may experience malabsorption due to changes in gut health or alterations in digestion. Additionally, CKD often is associated with reduced intrinsic factor production or alterations in its activity, which can further impair the absorption of vitamin B12, necessitating monitoring of this vitamin in affected individuals.

Folate, on the other hand, can be affected by kidney function as well. With CKD, there may be an increase in the excretion of folate due to impaired renal clearance, leading to lower overall levels. As a result, individuals with CKD often require close monitoring of both vitamin B12 and folate levels, adjusting dietary intake or supplementation as needed to prevent deficiencies that can lead to anemia and other health complications.

Thus, the correct answer reflects the need for monitoring due to the potential decreased absorption of these vitamins in the context of CKD.