Vitamin A supplementation is contraindicated or should be used with caution in which patient populations?

• A. Renal failure
• B. Liver failure
• C. Older adults
• D. Renal or liver failure and older adults

Answer: (D)

Vitamin A is a fat-soluble vitamin that can accumulate in the body if intake exceeds the capacity to store and metabolize it. In liver failure, the liver’s ability to store and metabolize vitamin A is impaired, so even standard supplementation can push stores toward toxicity and worsen liver injury. In renal failure, clearance and handling of retinoids can be altered, increasing the risk of accumulation and adverse effects despite normal dietary intake. Older adults often have reduced organ reserve (hepatic and renal function) and are on multiple medications, which raises the risk of toxicity from fat-soluble vitamins. Because these risks span liver disease, kidney disease, and age-related changes, supplementation should be avoided or used with caution in all these populations. That’s why the best approach is to exercise caution in those with renal or liver failure and in older adults.