Introduction: Patients with end-stage kidney disease (ESKD) suffer from functional iron deficiency where despite the presence of sufficient iron stores in the body, adequate iron is unavailable for heme synthesis. This study hypothesis was that in patients undergoing hemodialysis (HD), administration of intravenous (IV) ascorbic acid (AA) exerts a good effect on the management of anemia, either by increasing the mobilization of iron from tissue stores or acting as an antioxidant to overcome the inflammatory block and increase the erythropoietin sensitivity. Methods: Fifty patients with ESRD who were on regular HD were included in the study. Patients' ferritin levels ranged from 500 to 1200 ng/mL with transferrin saturation of 30% or more. However, all patients were anemic and received erythropoietin therapy. Iron therapy was discontinued in the first group, whereas it was continued in the second group that received IV AA. Results: A significant increase in the levels of Hb was observed in the second group after 6 months despite the decrease in ferritin levels in both the groups. Transferrin saturation decreased in both groups, the decrease being more in the first group. The levels of C-reactive protein (CRP) decreased in the second group, whereas these increased in the first group. Conclusions: Intravenous AA as an adjuvant therapy with iron exerts a favorable and significant effect on the Hb, serum ferritin, and CRP levels in patients with ESKD having anemia. The discontinuation of iron therapy only decreases the serum ferritin levels and does not improve the Hb or CRP levels.

Background The pathogenesis of vascular calcification in Chronic kidney disease (CKD) patients is multifactorial and complicated. It has been proposed that Magnesium (Mg) may be implicated in the process of vascular calcification on various levels. Aim This study aims to assess the level of magnesium in hemodialysis patients and its relation to the vascular stiffness. Patients and methods 100 prevalent hemodialysis patients were included in the study and they were clinically stable with absence of cardiovascular complications, all patients underwent the following laboratory investigation including complete blood picture, median of magnesium level over 3 months, electrolytes, ipth, lipid profile and radiological investigations including transthoracic echocardiography and carotid duplex. Results The studied population was divided into two groups, group I included 68 patients with normal mg level and group II included 32 patients with low mg level. There was statistically significant difference between the two groups as regard hemoglobin level (pvalue=0.033), otherwise there was no statistically significant difference as regard other laboratory and radiological investigations. Then they were divided into another two groups according to the presence of mitral valve calcification (MVC), group III involved 85 patients without MVC and group IV involved 15 patients with MVC. There was statistically significant difference between 2 groups as regard aortic wave pulse velocity (aPWV) with (pvalue=0.002), presence of plaques with (pvalue <0.001) and intimal media thickness with (pvalue<0.001). Another group was divided according to presence of aortic valve calcification (AVC) into two groups, first group V included 39 patients without AVC and second group VI included 61 patients with AVC. There was statistically significant difference between two groups as regard age with (pvalue<0.001), ipth with (pvalue=0.033), presence of plaques with (pvalue=0.048) and intimal media thickness with (pvalue<0.001). Conclusion There was high prevalence of vascular calcification among hemodialysis patients which may be related to age and hyperparathyroidism but without statistically significant correlation to Mg level.