Buradasınız

Anasayfa » Content

Farklı Dozlarda Vitamin C Tedavisinin Renal Anemi Üzerine Etkisi

The Effect of Different Doses of Vitamin C Treatment on Renal Anemia

Journal Name:

  • Uludağ Üniversitesi Tıp Fakültesi Dergisi

Publication Year:

  • 2002

Key Words:

Keywords (Original Language):

Author NameUniversity of Author
Abstract (2. Language): 
We have studied the effect of vitamin C therapy on renal anemia in 55 stable hemodialysis cases. The patients were divided into four groups. Three of the groups respectively received 100, 1000 and 2000 mg/day vitamin C therapy for 3 months. Vitamin C therapy was not applied to the control group. Hemoglobin (Hb), hematocrit (Hct), red cell counts and serum ferritin levels were measured before the treatment and at 1 st , 2 nd and 3 rd months of the treatment in all patients. After three months, in groups that received 100 and 1000 mg/day vitamin C therapy, mean Hb, Hct and red cell counts did not change significantly compared to those in pretreatment and in control group. In the group who received 2000 mg/day vitamin C therapy showed significantly increased mean Hb, Hct and red cell counts compared to the pretreatment counts. No significant changes were determined when compared to the control group. In order to better assess the effect of vitamin C on these changes, therapy was ceased in the same group for three months. However, no significant decrease was observed at mean Hb, Hct and red cell counts compared to the counts at the end of the three-month therapy period of the same group. In serum ferritin levels of all three groups, no statistically significant changes were observed compared to those in pretreatment and in control group. As a result, we came to the conclusion that the different doses of vitamin C therapy did not affect renal anemia in hemodialysis patients.
Bookmark/Search this post with
Abstract (Original Language): 
Bu çalışmada, 55 stabil hemodiyaliz hastasında farklı dozlarda vitamin C tedavisinin renal anemi üzerine olan etkisini inceledik. Hastalar dört gruba bölündü. Üç gruba 100, 1000 ve 2000 mg/gün dozlarında oral vitamin C üç ay süreyle verildi. Kontrol grubuna ise vitamin C uygulanmadı. Tedavi öncesi, tedavinin 1., 2. ve 3. aylarında hemoglobin (Hb), hematokrit (Hct), eritrosit ve serum ferritin düzeyleri ölçüldü. Üç ay sonra, 100 ve 1000 mg/gün vitamin C tedavisi alan gruplarda tedavi öncesi ve kontrol grubu ile karşılaştırıldığı zaman ortalama Hb, Hct ve eritrosit düzeylerinde anlamlı değişiklik saptanmadı. 2000 mg/gün vitamin C tedavisi alan grupta tedavi öncesi ile karşılaştırıldığı zaman ortalama Hb, Hct ve eritrosit düzeyleri anlamlı artış gösterdi. Kontrol grubu ile karşılaştırıldığında ise anlamlı değişiklik saptanmadı. Bu grupta anemide görülen olumlu etkinin vitamin C tedavisine bağlı olup olmadığını daha iyi değerlendirebilmek amacıyla vitamin C tedavisi 3 ay süreyle kesildi. Tedavi kesilmeden önceki değerlerle karşılaştırdığımızda ortalama Hb, Hct ve eritrosit düzeylerinde anlamlı azalma olmadı. Tedavi öncesi ve kontrol grubu ile karşılaştırıldığı zaman her üç grupta da ferritin düzeylerinde anlamlı bir değişiklik olmadı. Sonuç olarak çeşitli dozlarda vitamin C tedavisinin hemodiyaliz hastalarında renal anemi üzerine etkisi olmadığı kanaatine vardık.
FULL TEXT (PDF): 
PDF icon arastirmax-farkli-dozlarda-vitamin-c-tedavisinin-renal-anemi-uzerine-etkisi.pdf
  • 2
5-9
  • Turkish

REFERENCES

References: 

1. Mowry JA, Nissenson AR. Anemia in hematopoietic system in
uremia. In: Massry SG, Glassock RJ (eds). Textbook of
Nephrology. Baltimore: Williams and Wilkins; 1995. 1368-
78.
2. Yurtkuran M. Renal aneminin tedavisi. Uludağ Üniversitesi Tıp
Fakültesi Dergisi 1983; 2: 247-50.
3. Fisher JW. Mechanicsm of the anemia of chronic renal failure.
Nephron 1980; 25: 106-11.
4. Winearls CG. Treatment of anaemia in haemodialysis patients
with recombinant erythropoietin. Nephron 1989;
51(Suppl.1): 26-8.
5. Yawata Y, Jacob HS. Abnormal red cell metabolism in patients
with chronic uremia: nature of the defect and its persistence
despite adequate hemodialysis. Blood 1975; 45: 231-9.
6. Carrell RW, Winterbourn CC, Rachmilewitz EA. Activated
oxygen and haemolysis. Br J Haematol 1975; 30: 259-64.
7. Stocks J, Dormandy TL. The Autoxidation of human red cell
lipids induced by hydrogen peroxide. Br J Haematol 1971;
20: 95-111.
8. Morena M, Cristol JP, Canaud B. Why hemodialysis patients are
in a prooxidant state? What could be done to correct the
pro/antioxidant imbalance. Blood Purif 2000; 18: 191-9.
9. Maher ER, Wickens DG, Griffin JFA, Kyle P, Curtis JR,
Dormandy TL. Increased free-radical activity during
haemodialysis? Nephrol Dial Transplant 1987; 2: 169-71.
10. Schmidtmann S, vonBaehr R, Precht K. Free radicals induce
increased lysis of red blood cells after haemodialysis.
Nephrol Dial Transplant 1990; 5: 600-3.
11. Miguel A, Unares M. Evidence of increased susceptibility to lipid
peroxidation in red blood cells of chronic renal failure
patients. Nephron 1988; 50: 64-5.
12. Sullivan JF, Eisenstein AB. Ascorbic acid depletion in patients
undergoing chronic hemodialysis. Am J Clin Nutr 1970;
23: 1339-46.
13. Niki E. Vitamin C as an antioxidant. World Rev Nutr Diet 1991;
64: 1-30.
14. Baysal A, Keçecioğlu S, Arslan B ve ark., (eds). Besinlerin Bile-
şimi. Ankara: Yeniçağ; 1991.
15. Papastephanidis C, Agroyannis B, Tzanatos-Exarchov H et al. Reevaluation of ascorbic acid deficiency in hemodialysed
patients. Int J Artif Organs 1987; 10: 163-5.
16. Ono K. Secondary hyperoxalemia caused by vitamin C
supplementation in regular hemodialysis patients. Clin
Nephrol 1986; 26: 239-43.
17. Descombes E, Hanck AB, Fellay G. Water soluble vitamins in
chronic hemodialysis patients and need for
supplementation. Kidney Int 1993; 43: 1319-28. Farklı Dozlarda Vitamin C
9
18. Rolton HA, McConnell KM, Modi KS, MAcdougall A. The effect
of vitamin C intake on plasma oxalate in patients on regular
haemodialysis. Nephrol Dial Transplant 1991; 6: 440-3.
19. Ramirez G, Chen M, Boyce HW et al. Longitudinal follow-up of
chronic hemodialysis patients without vitamin
supplementation. Kidney Int 1986; 30: 99-106.
20. Petridou M, Sinakos Z, Vergoulas G. Effect of ascorbic acid on
the hematopoiesis of patients with chronic renal failure
receiving CAPD. Nephron 1988; 49: 175-6.
21. Tomson CRV, Channon SM, Parkinson IS et al. Correction of
subclinical ascorbat deficiency in patients receiving
dialysis: effects on plasma oxalate, serum cholesterol, and
capillary fragility. Clin Chim Acta 1989; 180: 255-64.
22. Ono K. The effect of vitamin C supplementation and withdrawal
on the mortality and morbidity of regular hemodialysis
patients. Clin Nephrol 1989; 31: 31-4.
23. Levine M. New concepts in the biology and biochemistry of
ascorbic acid. N Engl J Med 1986; 314: 892-902.
24. Roeser HP. The role of ascorbic acid in the turnover of storage
iron. Semin Hematol 1983; 20: 91-8.
25. Hussein S, Prieto J, O'Shea M, Hoffbrand AV, Baillod RA,
Moorhead JF. Serum ferritin assay and iron status in
chronic renal failure and haemodialysis. Br Med J 1978; 1:
546-8.
26. Lynn KL, Mitchell TR, Shepperd J. Serum ferritin concentration
in patients receiving maintenance hemodialysis. Clin
Nephrol 1980; 14: 124-7.
27. Van deVyver FL, Vanheule AA, Majelyne WM et al. Serum
ferritin as a guide for iron stores in chronic hemodialysis
patients. Kidney Int 1984; 26: 451-8.
28. Roeser HP, Halliday JW, Sizemore DJ, Nikles A, Willgoss D.
Serum ferritin in ascorbic acid deficiency. Br J Haematol
1980; 45: 457-66.
29. Cook JD, Watson SS, Simpson KM, Lipschitz DA, Skikne BS.
The effect of high ascorbic acid supplementation on body
iron stores. Blood 1984; 64: 721-6.
30. Giancaspro V, Nuzziello M, Pallotta G, Sacchetti A, Petrarulo F.
Intravenous ascorbic acid in hemodialysis patients with
functional iron deficiency: a clinical trial. J Nephrol 2000;
13: 444-9.
31. Tarng DC, Wei YH, Huang TP, Kuo BI, Yang WC. Intravenous
ascorbic acid as an adjuvant therapy for recombinant
erythropoietin in hemodialysis patients with
hyperferritinemia. Kidney Int 1999; 55: 2477-86.
32. Bull BS, Breton-Gorius J, Beutler E. Morphology of erythron. In:
Williams WY, Beutler E, Erslev AJ, Lichtman MA (eds).
Hematology. NewYork: Mc Graw Hill; 1991. 297-316.
33. McCay PB. Vitamin E: interactions with free radicals and
ascorbate. Annu Rev Nutr 1985 ; 5: 323-40.
34. Rosenmund A, Binswanger U, Straub PW. Oxidative injury to
erythrocytes, cell rigidity, and splenic hemolysis in
haemodialysis uremic patients. Ann Intern Med 1975; 82:
460-5.
35. Stocks J, Offerman EL, Modell CB, Dormandy TL. The
susceptibility to autoxidation of human red cell lipids in
health and disease. Br J Haematol 1972; 23: 713-24.
36. Ghoreshi Z, Jagtap PE, Ahaley SK, Gandhi R. Oxidantantioxidant status in acute and chronic renal failure. Indian
J Med Sci 2000; 54: 131-5.
37. Seth RK, Saini AS, Aggorwai SK. Glutathion peroxidase activity
and reduced glutathion content in erythrocytes of patients
with chronic renal failure. Scand J Haematol 1985; 35:
201-4.
38. Costogliola C, Romano L, Scibelli G, deVincetiis A, Sorice P, Di
Benedetto A. Anemia and chronic renal failure a
therapeutical approach by reduced glutathione parenteral
administration. Nephron 1992; 61: 404-8.
39. Maccarrone M, Meloni C, Manca-di-Villahermosa S et al. Vitamin E suppresses 5-lipoxygenase-mediated oxidative stress
in peripheral blood mononuclear cells of hemodialysis
patients regardless of administration route. Am J Kidney
Dis 2001; 37: 964-9.
40. Rees S. Ascorbic acid and lipid peroxidation. The cross-over
effect. Acta Biochim Biophys Hung 1987; 22: 241-9.
41. Wayner DDM, Burton GW, Ingold KV. The antioxidant
efficiency of vitamin C is concentration dependent.
Biochim Biophys Acta 1986; 884: 119-23.
42. Aruomo OI, Halliwell B. Superoxide dependent and ascorbatedependent formation of hydroxyl radicals from hydrogen
peroxide in the precense of iron. Are lactoferrin and
transferrin prometers of hydroxyl-radical generation?
Biochem J 1987; 241: 273-8.
43.Roob JM, Khoschsorur G, Tiran A, Horina JH, Holzer H,
Winklhofer-Roob BM. Vitamin E attenuates oxidative
stress induced by intravenous iron in patients on
hemodialysis. J Am Soc Nephrol 2000; 11: 539-49.

Thank you for copying data from http://www.arastirmax.com