IV Ascorbic Acid May Benefit EPO Resistant Patients

SAN DIEGO—Intravenous ascorbic acid (IVAA) can be a potent and effective adjuvant treatment for hemodialysis patients who have normoferritinemic anemia resistant to treatment with erythropoietin (EPO), according to findings presented at Kidney Week 2012.

In addition, IVAA can decrease the dosage of ESAs for anemia correction.

Researchers at Chosun University Hospital in Gwangju, Korea, studied 58 HD patients with normoferritemic anemia hyporesponsive to EPO. They assigned 33 patients to received IVAA. The remaining 25 patients served as controls.

The treatment group received 500 mg IVAA with each dialysis session for three months. Of the 33 patients, 20 had a response to IVAA with significant increases in their hemoglobin (greater than 1.0 g/dL) and reduction of weekly EPO dose compared with controls after three months of treatment. At baseline, transferrin saturation (TSAT) was significantly decreased in responders compared with nonresponders (26% vs. 35%). After three months, the responders experienced a significant rise in serum iron levels (from 57 at baseline to 108 µg/dL) and TSAT (from 26% to 52%) and decrease in serum ferritin (from 377 to 233 ng/mL), whereas the nonresponders had no significant changes in these parameters.