Nephrology 2008;13:17-22


Ascorbate deficiency is common among peritoneal dialysis (PD) patients and can be identified readily with serum ascorbate measurements, researchers in Australia report.

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Paolo Ferrari, MD, and his colleagues at the University of Western Australia in Perth measured serum ascorbate levels in 45 clinical stable PD patients to determine the prevalence of ascorbate deficiency (2-4 mg/L) and deficiency (less than 2 mg/L). Eighteen patients (41%) were regularly taking ascorbate-containing multivitamins; 27 (59%) were not taking any ascorbate supplements. Ascorbate deficiency was found in 15 patients (33%), and ascorbate insufficiency was found in nine patients (20%). No patients had clinical manifestations of scurvy.


The researchers obtained follow-up ascorbate levels in 12 stable patients with baseline ascorbate levels below 4 mg/L after a median of three months from baseline. Targeted ascorbate supplementation in these patients increased the median serum ascorbate level from 1.7 to 22.5 mg/L.


The investigators suggest measuring ascorbate levels in all PD patients at the initiation of dialysis, with a target level in the normal range (4-14 mg/L).


“Oral supplements in the form of inexpensive multivitamin preparations restore adequate serum ascorbate levels in the majority of these patients,” the authors concluded. They stated that a supplementation dose of 120 mg as part of a commercial multivitamin preparation appears to be safe and effective at raising ascorbate levels.