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NDT Advance Access originally published online on November 14, 2006
Nephrology Dialysis Transplantation 2007 22(2):328-331; doi:10.1093/ndt/gfl534
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© The Author [2006]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Vitamin C deficiency in dialysis patients—are we perceiving the tip of an iceberg?

Garry J. Handelman

University of Massachusetts, Lowell, MA 01854 and Renal Research Institute, New York, NY 10128, USA

Correspondence and offprint requests to: Garry J. Handelman, 3 Solomont Way, University of Massachusetts, Lowell, MA, 01854, USA. Email: garry_handelman@uml.edu

Keywords: anemia; haemodialysis; iron; oxalosis; vitamin C

The first 150 words of the full text of this article appear below.



   Summary of the problem
 
The occurrence of vitamin C deficiency has complicated the management of dialysis patients since the beginning of renal replacement therapy [1]. The major portion of dietary vitamin C is provided by potassium-rich foods such as orange juice, strawberries and broccoli, but these foods are restricted for haemodialysis (HD) patients because HD removes potassium with limited efficiency. Hyperkalaemia is potentially a major risk factor for dialysis morbidity and mortality [2], and one of the chief responsibilities of the renal dietitian is to instruct the patient to limit the intake of potassium-rich foods [3]. Under these circumstances, low dietary vitamin C intake can readily occur. Since vitamin C is partly metabolized to oxalate, which can accumulate in renal failure patients, many clinicians only recommend a dose of 60–100 mg/day, which may not be optimal. The problem is made more severe by vitamin C losses during dialysis, . . . [Full Text of this Article]



   Vitamin C and erythropoiesis
 


   Vitamin C deficiency and scurvyin dialysis patients
 


   Vitamin C and oxalosis
 


   Summary and conclusions
 

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