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دانشگاه علوم پزشکی و خدمات بهداشتی درمانی زنجان

Effect of short-term intravenous ascorbic acid on reducing ferritin in hemodialysis patients

(2012) Effect of short-term intravenous ascorbic acid on reducing ferritin in hemodialysis patients. Indian Journal of Nephrology. pp. 168-173.

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Abstract

Resistance to recombinant erythropoietin (rEPO) in hemodialysis patients may be due to inadequate iron recruitment and defect in iron use. In this cross over randomized clinical trial, 30 hemodialysis patients with serum ferritin levels of ≥500 ng/ml, hemoglobin 11.0 g/dl, and transferrin saturation (TSAT) of 20% or less were administrated intravenous iron (50-100 mg/wk) and rEPO (120-360 U/kg/wk) for 6 months. Patients were excluded if there was a clear explanation for rEPO hyporesponsiveness. Patients were divided into two groups. Group1 received standard care and 500 mg of intravenous ascorbic acid (IVAA) with each dialysis session in the first week of each month for a total of 3 months. Group 2 received standard care only. After 2 month washout period, groups were crossed over. Each month hemoglobin (Hb) was assessed. Iron, TIBC (transferrin iron binding capacity), TSAT, iPTH (intact parathyroid hormone), liver enzymes, albumin and cholesterol levels were measured every 3 months. After 3 months of intervention, Hb significantly increased from 10.11 to 12.19 g/dl (P <0 0.001; 95% confidence interval [CI] 2.7-1.4) and TSAT increased from 18.9 to 28.1% (P = 0.008; 95% CI 0.09-3), while ferritin and serum iron declined significantly from 1391 to 938 ng/ml (P = 0.001; 95% CI 216-689), 97.2 to 64.6 (P = 0.001; 95% CI 14.8-50.4) in the study group. Change of Hb over time in IVAA group was significant (P < 0.0005). There were significant differences between two groups in change of Hb level over time (P < 0.0005) and treatment effect (P = 0.002). Baseline laboratory tests were similar in the two groups and there was no carry over effect at phase 2. We showed that low amount of IVAA could reduce ferritin level and enhance Hb and TSAT, suggesting improved iron utilization. SciVal Topic Prominence Topic: Renal Dialysis | Oxidative Stress | hemodialysis HD Prominence percentile: 81.519 Author keywords Anemiaascorbic acidhemodialysis Indexed keywords EMTREE drug terms: albuminascorbic acidcholesterolferritinhemoglobinironliver enzymeparathyroid hormonerecombinant erythropoietintransferrin EMTREE medical terms: adultarticleclinical articlecontrolled studycrossover proceduredrug effectfemaleferritin blood levelhemodialysishemodialysis patienthumanintervention studyiron binding capacitymaleshort course therapytreatment response Chemicals and CAS Registry Numbers: ascorbic acid, 134-03-2, 15421-15-5, 50-81-7; cholesterol, 57-88-5; ferritin, 9007-73-2; hemoglobin, 9008-02-0; iron, 14093-02-8, 53858-86-9, 7439-89-6; parathyroid hormone, 12584-96-2, 68893-82-3, 9002-64-6; recombinant erythropoietin, 113427-24-0, 122312-54-3, 130455-76-4, 148363-16-0, 154725-65-2, 879555-13-2; transferrin, 82030-93-1 ISSN: 09714065 Source Type: Journal Original language: English DOI: 10.4103/0971-4065.86407 Document Type: Article References (36) View in search results format All 1 Locatelli, F., Aljama, P., Bárány, P., Canaud, B., Carrera, F., Eckardt, K.U., Hörl, W.H., (...), Cameron, S. 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Cited 39 times. doi: 10.1093/oxfordjournals.ndt.a091615 View at Publisher 36 Canavese, C., Petrarulo, M., Massarenti, P., Berutti, S., Fenoglio, R., Pauletto, D., Lanfranco, G., (...), Marangella, M. Long-term, low-dose, intravenous vitamin C leads to plasma calcium oxalate supersaturation in hemodialysis patients (2005) American Journal of Kidney Diseases, 45 (3), pp. 540-549. Cited 51 times. http://www.elsevier.com/inca/publications/store/6/2/3/2/7/6/index.htt doi: 10.1053/j.ajkd.2004.10.025 View at Publisher Ghadiani, M.H.; Department of Nephrology, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Iran; email:jmojgan@zums.ac.ir © Copyright 2012 Elsevier B.V., All rights reserved. Back to results 1of1 Top of page Metrics Learn more about Article metrics in Scopus (opens in a new window) View all metrics 5 Citations in Scopus 35th percentile 0.29 Field-Weighted Citation Impact PlumX Metrics Usage, Captures, Mentions, Social Media and Citations beyond Scopus. 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Item Type: Article
Keywords: Renal Dialysis | Oxidative Stress | hemodialysis HD
Page Range: pp. 168-173
Journal or Publication Title: Indian Journal of Nephrology
Abstract and Indexing: Pubmed, Scopus
Volume: 22
Number: 3
Publisher: scopus
Depositing User: خانم مریم زرقانی
URI: http://repository.zums.ac.ir/id/eprint/1438

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