Nephrol Dial Transplant Vol. 19 No. 9 © ERA-EDTA 2004; all rights reserved
Original Article
Vitamin C plasma level and response to erythropoietin in patients on maintenance haemodialysis
1 Universitätsklinik für Innere Medizin III, Klinische Abteilung für Nephrologie und Dialyse, 2 Klinisches Institut für Medizinische und Chemische Labordiagnostik and 3 Universitätsklinik für Innere Medizin II, Klinische Abteilung für Angiologie, Vienna, Austria
Correspondence and offprint requests to: Robert Deicher, MD, Universitätsklinik für Innere Medizin III, Klinische Abteilung für Nephrologie und Dialyse, Währinger Gürtel 18–20, 1090 Wien, Austria. Email: robert.deicher{at}nephro.imed3.akh-wien.ac.at
Background. Intravenous vitamin C supplementation to haemodialysis patients might ameliorate responsiveness to recombinant human erythropoietin (rHuEpo). This study was performed to analyse the relation between vitamin C plasma concentration and response to rHuEpo.
Methods. In a cross-sectional, single-centre observational study including all haemodialysis patients, pre-dialysis plasma vitamin C concentrations were measured by high-performance liquid chromatography and response to rHuEpo (haemoglobin concentration/international units rHuEpo/kg/week) was recorded together with baseline laboratory data.
Results. Univariate analysis yielded a significant correlation between vitamin C plasma levels and response to rHuEpo (n = 130, r = 0.25, P = 0.004), which still persisted after adjustment for transferrin saturation, C-reactive protein, malondialdehyde, parathyroid hormone, route of rHuEpo administration, residual renal function and diabetes mellitus (adjusted r = 0.23, P = 0.014). Analysis per quartiles of vitamin C plasma level revealed a significantly lower response to rHuEpo with decreasing vitamin C values (P = 0.026).
Conclusions. In unselected haemodialysis patients, vitamin C plasma levels account, at least partially, for the response to rHuEpo. Larger-sized interventional studies are needed to find out whether vitamin C plasma levels may or may not appropriately reflect the potential beneficial effect of vitamin C supplements on rHuEpo responsiveness.
Keywords: anaemia; chronic kidney disease; erythropoietin; vitamin C
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