title: Intravenous ascorbic acid administration for erythropoietin-hyporesponsive anemia in iron loaded hemodialysis patients.
abstract: Intravenous ascorbic acid administration (IVAA) could override recombinant human erythropoietin (rHuEPO) resistance in hemodialysis patients with iron overload. We investigated the hematopoietic response to IVAA in iron-overloaded hemodialysis patients. We included 36 patients whose ferritin levels were higher than 500 microg/L and who needed more than 100 U/kg/week of rHuEPO. The study included an initial phase (500 mg IVAA twice weekly was administered to all of the patients for 8 weeks) and a maintenance phase (patient groups were formed; Group 1 received IVAA 500 mg/week for 8 weeks and Group 2 received no therapy). We observed a significant increase in hematocrit and transferrin saturation and a decrease in the percentage of hypochromic red cells and ferritin levels at the end of the initial phase. The total weekly-required rHuEpo dose and rHuEpo/hemoglobin also fell significantly after the initial phase. The response remained stable in patient groups during the maintenance phase. In 6 nonresponders, the hypochromic red cells were <10%. In conclusion, IVAA effectively overrides rHuEPO resistance in iron-overloaded hemodialysis patients.
authors.affiliation: Department of Nephrology, Başkent University Faculty of Medicine, Ankara, Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Sezer
authors.forename: F N
authors.initials: FN
authors.lastname: Ozdemir
authors.forename: U
authors.initials: U
authors.lastname: Yakupoglu
authors.forename: Z
authors.initials: Z
authors.lastname: Arat
authors.forename: M
authors.initials: M
authors.lastname: Turan
authors.forename: M
authors.initials: M
authors.lastname: Haberal
mesh_terms: D000328:Adult; D018798:Anemia, Iron-Deficiency; D001205:Ascorbic Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D004351:Drug Resistance; D004921:Erythropoietin / Q000627:therapeutic use*; D005260:Female; D006410:Hematopoiesis; D006801:Humans; D019190:Iron Overload / Q000209:etiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins; D006435:Renal Dialysis / Q000009:adverse effects*
chemical_list: D011994:Recombinant Proteins; D004921:Erythropoietin; D001205:Ascorbic Acid