Effect of ascorbic acid administration in hemodialysis patients on in vitro oxidative stress parameters: influence of serum ferritin levels

Chen, Wei Teing; Lin, Yuh Feng; Yu, Fei; Kao, Woei Yau; Huang, Wei; Yan, Horng Chin

doi:10.1016/s0272-6386(03)00419-0

Cited by 26 publications

(11 citation statements)

References 32 publications

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“…From our data, it appears to be decreased regardless of urate levels, as demonstrated with the decreased FRAP after HD in our patients, and implies that urate may indeed affect thiol levels; however, the depletion of antioxidants cannot be solely related to a single redox parameter. This is further supported by observations on the pro‐oxidant effect of intravenous supplementation of ascorbic acid in HD patients, despite its strong antioxidant effect in the DPPH reaction (18), and the significant impairment of TAC after oral α‐tocopherol administration in HD patients (19).…”

Section: Discussionsupporting

confidence: 56%

Serum Antioxidant Capacity is Preserved in Peritoneal Dialysis Contrary to Its Robust Depletion After Hemodialysis and Hemodiafiltration Sessions

Rysz¹,

Stolarek

Pedzik³

et al. 2010

Ther Apher Dial

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Renal replacement therapy (RRT) may differentially affect systemic generation of reactive oxygen species and depletion of antioxidant pools of low molecular weight molecules and proteins. This study was designed to assess the magnitude of the impairment of serum total antioxidant capacity (TAC) in relation to different RRT modalities. The study included patients on continuous ambulatory peritoneal dialysis (CAPD, N = 21), hemodialysis (HD, N = 21), hemodiafiltration (HDF, N = 20), and healthy controls (N = 33). TAC was assessed by the ferric reducing ability of plasma (FRAP) and with the 2,2-diphenyl-1-picryl-hydrazyl (DPPH) assay. In CAPD patients, predialysis FRAP and DPPH were increased: 1.46 mM and 10.5% vs. control 1.19 mM and 7.2%, respectively (P < 0.001 in each). In HD and HDF patients, the FRAP and DPPH were significantly increased before and lowered after the RRT session (P < 0.05) if compared with healthy controls. During an HD session, FRAP was decreased from pre-HD 1.71 +/- 0.29 mM to post-HD 0.85 +/- 0.20 mM (P = 0.0001). The decrease of FRAP was lower during HDF (P < 0.05 vs. HD), it decreased from pre-HDF 1.41 +/- 0.43 mM to post-HDF 0.87 +/- 0.23 mM (P = 0.0001 vs. pre-HDF). The HD session decreased DPPH from the pre-HD median 10.3%, interquartile range (IR) 9.3-12.0% to post-HD 2.6% IR 2.3-3.1% (P < 0.0001). The adjustment of either urate or bilirubin up to pre-HD levels did not restore lowered post-HD levels of TAC. TAC remains preserved in CAPD, whereas the robust depletion of TAC, lower after HDF than HD sessions, cannot be attributed solely to the washout of dialyzable compounds.

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Section: Discussionsupporting

confidence: 56%

Serum Antioxidant Capacity is Preserved in Peritoneal Dialysis Contrary to Its Robust Depletion After Hemodialysis and Hemodiafiltration Sessions

Rysz¹,

Stolarek

Pedzik³

et al. 2010

Ther Apher Dial

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“…Hydroxyl radical started the process of lipoperoxidation. This supports the idea that high levels of vitamin C make its pro-oxidant action apparent [20] .…”

Section: Discussionsupporting

confidence: 81%

“…These associations were documented during and after Fe iv administration. TBARS levels prior to HD and (20)(21)(22)(23)(24)(25)(26)(27) Values No adverse reactions of patients to the agents used were seen. Patients were in good condition throughout the study.…”

Section: Substudy B -Administration Of Fe IV (Or Saline) With (Or Witmentioning

confidence: 93%

The Effect of Intravenous Iron on Oxidative Stress in Hemodialysis Patients at Various Levels of Vitamin C

Eiselt¹,

Ráček²,

Opatrný³

et al. 2006

Blood Purif

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Background/Aims: Vitamin C levels decrease during hemodialysis (HD), which deteriorates antioxidant defense. Vitamin C may also act pro-oxidatively, via reduction in Fe(III). We sought to determine whether intravenous iron (Fe_iv)-induced oxidative stress differs in HD patients with low and physiological vitamin C levels and whether intravenous vitamin C (C_iv) administration during HD would change the response to Fe_iv. Patients and Methods: Twenty patients with vitamin C deficiency (median 15.7 µmol/l, range 8.0–22.7) received Fe_iv (100 mg iron sucrose between 150 and 180 min of HD). After 4 weeks of oral supplementation, the levels of vitamin C were comparable with those of controls (60.1 µmol/l, range 47.4–70.9). Patients were subsequently treated with (1) Fe_iv, (2) Fe_iv and continuous 2 mg/min C_iv throughout HD, (3) saline (S), and (4) S+C_iv. Plasma thiobarbituric acid reacting substances (TBARS) and vitamin C were assessed before, during and after FE_iv(S), and 15, 30 and 60 min after infusion. Results: Fe_iv induced a comparable rise in TBARS in patients with vitamin C deficiency (before Fe_iv, 1.9 µmol/l, range 1.4–1.9; after Fe_iv, 2.6 µmol/l, range 2.3–2.9; p < 0.01) and in those with normal vitamin C (before Fe_iv, 1.9 µmol/l, range 1.7–2.1; after Fe_iv, 2.6 µmol/l, range 2.5–2.9; p < 0.01). Fe_iv+C_iv resulted in a greater increase in TBARS (after Fe_iv, 3.1 µmol/l, range 2.8–3.2) compared with Fe_iv (p < 0.01). Conclusion: Iron sucrose-induced oxidative stress is comparable in HD patients with vitamin C deficiency and in those with normal vitamin C. We documented a pro-oxidative effect of vitamin C during Fe_iv+C_iv administration.

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“…Vitamin C recycles Fe 3+ back to Fe 2+ , thus promoting a vicious circle with continuous generation of reactive oxygen species. Excessive free radical formation in vitro was confirmed when vitamin C was administered to hemodialysis patients, especially in those with high ferritin levels [24]. In vivo, however, the bioavailability of catalytic free iron is thought to be very low, as it is readily sequestered by iron binding proteins such as transferrin [8].…”

Section: Discussionmentioning

confidence: 99%

Oral Vitamin C Administration Increases Lipid Peroxidation in Hemodialysis Patients

Vriese¹,

Borrey

Mahieu

et al. 2007

Nephron Clin Pract

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Background: Since vitamin C (ascorbic acid, AA) deficiency is common in hemodialysis patients, systematic supplementation has been recommended. Further, vitamin C has been advocated as a potential adjuvant to erythropoietin by virtue of its capacity to improve iron utilization. However, vitamin C may have a paradoxical pro-oxidant effect in the presence of iron. Methods: In 109 hemodialysis patients, oral vitamin C was administered at 360 and 1,500 mg/week during 3 months each, followed by a wash-out period of 3 months. Results: Serum AA increased from 0.22 to 0.33 and 0.63 mg/dl after 360 and 1,500 mg/week, respectively. However, a commensurate increase of plasma malondialdehyde (MDA), a parameter of lipid peroxidation, with 9 and 26% was observed. Serum AA and plasma MDA returned to baseline after withdrawal of vitamin C. Parameters of iron status, nutrition, inflammation, dialysis efficiency and plasma lipids remained unaltered. In a stepwise multiple regression analysis, serum AA and ferritin were strong and independent predictors of MDA. Conclusion: Oral vitamin C supplementation in hemodialysis patients increases lipid peroxidation, especially in patients with increased serum ferritin. The potential benefits of restored vitamin C status and improved erythropoiesis may be entirely overruled by the adverse consequences of oxidative tissue injury.

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Effect of ascorbic acid administration in hemodialysis patients on in vitro oxidative stress parameters: influence of serum ferritin levels

Cited by 26 publications

References 32 publications

Serum Antioxidant Capacity is Preserved in Peritoneal Dialysis Contrary to Its Robust Depletion After Hemodialysis and Hemodiafiltration Sessions

Serum Antioxidant Capacity is Preserved in Peritoneal Dialysis Contrary to Its Robust Depletion After Hemodialysis and Hemodiafiltration Sessions

The Effect of Intravenous Iron on Oxidative Stress in Hemodialysis Patients at Various Levels of Vitamin C

Oral Vitamin C Administration Increases Lipid Peroxidation in Hemodialysis Patients

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