Vitamin C May Improve Resistant Anemia in HD Patients

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DENVER—A Korean study suggests that vitamin C may benefit hemodialysis (HD) patients with anemia resistant to treatment with erythropoietin (EPO).

The study, by Ji-Min Jeon, MD, of Dong Rae Bong Seng Hospital in Busan, Korea, and colleagues, included 47 HD patients with Hb levels below 11 g/dL and hyperferritinemia (ferritin levels greater than 300 ng/mL). Sixteen patients received standard care (group 1), 17 patients received standard care and daily oral vitamin C at a dosage of 500 mg a day (group 2), and 14 patients received standard care plus 300 mg of IV vitamin C with each dialysis session (group 3).

After three months, Hb, hematocrit, and TSAT increased significantly in groups 2 and 3, but remained unchanged in group 1. Hb levels rose from 8.8 g/dL at baseline to 9.5 g/dL after three months in group 2, and from 9.0 to 9.6 g/dL in group 3. In group 1, Hb levels remained stable (8.9 at baseline vs. 8.8 g/dL after three months).

EPO dose decreased significantly in groups 2 and 3, but not in group 1. EPO doses (in units per week) dropped from 15,584 to 12,369 in group 2 and from 14,986 to 11,345 in group 3. In group 1, the EPO dose was 14,729 at baseline and 14,538 after three months.

The researchers concluded that IV and oral vitamin C therapy can improve anemia, hyperferritemia and EPO resistance in HD patients, and that the effect of IV and oral vitamin C are similar.

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