Effect of oral vitamin C on serum hepcidin level, iron status and inflammation among hemodialysis patients with functional iron deficiency anaemia
Publish place: Journal of Renal Endocrinology، Vol: 7، Issue: 1
Publish Year: 1400
نوع سند: مقاله ژورنالی
زبان: English
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شناسه ملی سند علمی:
JR_JRE-7-1_016
تاریخ نمایه سازی: 30 مرداد 1401
Abstract:
Introduction: Hepcidin is a key regulatory peptide in iron homeostasis, the pathogenesis of functional iron deficiency (FID) anemia and erythropoiesis-stimulating agent (ESA) resistance is contributed to the inflammatory mediated increase in the serum hepcidin levels among prevalent hemodialysis (HD) patients.Objectives: To test the reducing therapeutic effect of oral vitamin C supplements on hepcidin levels and iron status among HD patients with FID anemia.Patients and Methods: This study is an interventional prospective cohort study; ۴۸ prevalent HD patients were enrolled. Group one: ۳۱ patients who received the conventional treatment of erythropoietin stimulating agents together with oral supplementation of vitamin C ۵۰۰ mg every other day dose for ۳ months. Group two: ۱۷ patients who received only the conventional therapy of erythropoietin stimulating agents. Patients with hemoglobin level <۱۱ g/dL, ferritin level >۲۰۰ ng/mL and transferrin saturation (TSAT) >۲۰ % were included. Laboratory parameters: serum hepcidin, high-sensitivity C-reactive protein (hs-CRP) titre, CBC, and iron indices were measured at baseline and after ۳ months.Results: On comparing the two groups, oral vitamin C in group ۱ resulted in a statistically significant reduction in hepcidin levels [mean ۲۵۰۶.۴۵۶ ± ۱۳۲۰.۵۳ pg/mL to ۱۷۴۸.۳۹۶ ± ۱۴۳۲.۲۸ pg/mL (P = ۰.۰۳)], and a significant reduction in hs-CRP level [mean ۸۶۰۳.۲۳۶ ± ۲۵۴۷.۷۷ ng/mL to ۵۶۱۱.۲۹۶ ± ۲۸۲۹.۲۷ ng/mL] (P = ۰.۰۰۱) after three months of treatment in comparison to control group. A decrease of EPO requirement and elevation of hemoglobin level were observed in a study group with oral vitamin C.Conclusion: Oral vitamin C may be a promising therapy in decreasing serum hepcidin and inflammatory markers among prevalent HD patients with FID anemia.
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Authors
Maha A. Behairy
Internal Medicine and Nephrology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Ahmed Gharib
Internal Medicine and Nephrology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Mahmoud Zaki
Internal Medicine and Nephrology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Reem El Sharabasy
Internal Medicine and Nephrology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt