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Saudi Journal of Kidney Diseases and Transplantation
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ORIGINAL ARTICLE Table of Contents   
Year : 2008  |  Volume : 19  |  Issue : 6  |  Page : 933-936
Effect of intravenous ascorbic acid in hemodialysis patients with anemia and hypeferritinemia


1 Department of Oncology, Azad University of Tonekabon, Ramsar, Iran
2 Department of Nephrology, Mazandaran University of Medical Science, Sari, Iran

Correspondence Address:
Omolbanin Taziki
Department of Nephrology, Mazandaran University of Medical Science, Sari
Iran
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PMID: 18974579

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Hemodialysis (HD) patients with functional iron deficiency (FID) often develop resistance to recombinant human erythropoietin (Epo). The contributory role of chronic infla­mmation and oxidative stress in its pathogenesis is poorly understood. We assessed the effect of vitamin C, an antioxidant, on Epo-hyporesponsive anemia in hemodialysis patients with un­explained hyperferritinemia levels. Thirty-one of 132 with Hb < 11 g/dL were prospectively fo­llowed up after exclusion of reasons for Epo hyporesponsiveness. Patients were randomly divided into two groups: 15 patients received standard care and 300 mg of intravenous vitamin C with each dialysis session (group 1) and 15 patients received standard care (group 2). After 3 months, Hb and transferrin saturation levels significantly increased in group 1 but not in group 2 (p < 0.05%). Hemoglobin content in reticulocyte and serum ferritin decreased significantly in group 1 but not in control group. In conclusion, hemodialysis patients with refractory anemia and ade­quate iron stores, vitamin C improved responsiveness to Epo by augmenting iron mobilization and possibly via antioxidant effect.


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