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HEMODİYALİZ HASTALARINDA FONKSİYONEL DEMİR EKSİKLİĞİNİN TEDAVİSİNDE İNTRAVENÖZ ASKORBİK ASİT'İN KULLANIMI

INTRAVENOUS ASCORBIC ACID IN HEMODIALYSIS PATIENTS WITH IRON DEFICIENCY

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Abstract (2. Language): 
Background: Functional iron deficiency may develop and cause recombinant human erytropoietin (rHuEpo) resistance in hemodialysis patients (HD) with iron overload. The aim of this study was to show the effects of intravenous ascorbic acid on functional iron deficiency in HD. Patients and Methods: Thirty-four HD patients with serum ferritin>500pg/l, transferin saturation (TS) <% 20 and hemoglobin (Hb) <10 g/dl were randomly divided into two groups. In group I patients (n-16) did not receive any adjuvant therapy. In group II patient (n=18) intravenous ascorbic acid 500 mg was administered three times a week for 12 weeks. Results: All patient completed the study. The mean values ofHb, Hct, TS, and ferritin remained unchanged in group I after 12 weeks. Mean values ofHb, Hct, and TS significantly increased (basaline vs 12 weeks, Hb 9.2+0.3 g/dl vs 10.8+O.3 g/dl, Hct 27.6+0.9% vs 32+0.6%, TS 17.3+1.2% vs 29.9±1.3% respectively p<0.001) in group II after 12 weeks; ferritin fell significantly from 866± 245 i/l vs 646± 219 1 (p<0.001). Conclusion: In this study, 300 mg intravenous ascorbic acid therapy on functional iron deficiency in HD patients was effectively.
Abstract (Original Language): 
Giriş ve Amaç: Hemodiyaliz (HD) hastalarında aşırı demir birikimine bağlı olarak recombinant human erytropoietin (rHuEpo)'e direnç gelişmesi nedeni ile fonksiyonel demir eksikliği gelişebilir. Bu çalışmada fonksiyonel demir eksikliği olan HD hastalarında intravenöz askorbik asitin etkisini göstermeyi amaçladık. Materyal ve Metod: Serum ferritin>500 ıg/l, transferrin satürasyonu (TS) <%20 ve hemoglobin (Hb) <10 g/dl olan 34 HD hastası rastgele iki gruba ayrıldı. 1. gruptaki hastalar (n=16) hiçbir tedavi almadı. II. gruptaki hastalara (n=18) haftada 3 gün 500 mg/gün intravenöz askorbik asit 72 hafta uygulandı. Bulgular: Bütün hastalar çalışmayı tamamladılar. Ortalama Hb, Hct, TS, ve ferritin seviyeleri I. grupta 12 hafta sonunda değişmeden kaldı (p>0.05). Ortalama Hb, Hct, ve TS seviyeleri II. grupta 72 hafta sonunda önemli derecede artn.(Bazal ve 12 hafta sonraki değerleri sırasıyla Hb 9.2±0.3 g/dl - 10.8±0.3 g/dl, Hct% 27.6+0.9 - %32±0.6, TS %17.3±1.2 - %29.9±1.3 olarak bulundu p<0.001). Serum ferritin düzeyleri ise 12 hafta sonra (866+ 245 //// -646± 219 /<//) önemli derecede azaldı p<0.001). Sonuç: Bu çalışmada fonksiyonel demir eksikliği olan HD hastalarında 300 mg intravenöz askorbik asit etkili bulundu.
FULL TEXT (PDF): 
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