title: The efficacy of ascorbic acid in suboptimal responsive anemic hemodialysis patients receiving erythropoietin: a meta-analysis.
abstract: BACKGROUND
  To determine the impact of adjuvant ascorbic acid therapy on erythropoietin-hyporesponsive, anemic patients undergoing hemodialysis.
  
  
  METHODS
  The online databases of PubMed, Cochrane library, IPA, CINAHL, EMBASE, clinicaltrial.gov, WHO trial registry and PyschINFO were used.
  
  
  METHODS
  Studies comparing ascorbic acid to a control, with participants receiving erythropoietin and hemodialysis, and reported outcomes for hemoglobin or transferring saturation.
  
  
  METHODS
  Two independent researchers reviewed titles and abstracts to determine relevance and extracted study design, dose, duration, baseline values, and outcomes.
  
  
  RESULTS
  Five studies met all the criteria and were used for final analysis. The calculated weighted mean difference between hemoglobin in the ascorbic acid group versus the control group was 0.96 g/dL (95% CI, 0.78 to 1.14). The calculated weighted mean difference between transferrin saturation in the ascorbic acid treatment group versus the control was 8.26% (95% CI, 6.59 to 9.94).
  
  
  CONCLUSIONS
  Adjuvant ascorbic acid significantly raises hemoglobin levels in patients with erythropoietin hyporesponsiveness undergoing hemodialysis. The significant rise in transferrin saturation indicates that this positive effect on erythropoietin response may be due to increased iron utilization.
authors: Center of Pharmaceutical Outcomes Research, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand.
authors: Brad
authors: B
authors: Einerson
authors: Nathorn
authors: N
authors: Chaiyakunapruk
authors: Chagriya
authors: C
authors: Kitiyakara
authors: Sirada
authors: S
authors: Maphanta
authors: Visanu
authors: V
authors: Thamlikitkul
mesh_terms: D000328:Adult; D000740:Anemia / Q000188:drug therapy*; D000975:Antioxidants / Q000627:therapeutic use*; D001205:Ascorbic Acid / Q000627:therapeutic use*; D004921:Erythropoietin / Q000627:therapeutic use*; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007275:Injections, Intravenous; D007501:Iron / Q000378:metabolism / Q000627:therapeutic use; D019190:Iron Overload / Q000188:drug therapy; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications / Q000628:therapy; D008297:Male; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D006435:Renal Dialysis
chemical_list: D000975:Antioxidants; D006454:Hemoglobins; D004921:Erythropoietin; D007501:Iron; D001205:Ascorbic Acid