Shahrbanoo Keyhanian, Taziki Omolbanin
Department of Oncology, Azad University of Tonekabon, Ramsar, Iran.
Saudi J Kidney Dis Transpl. 2008 Nov;19(6):933-6.
Hemodialysis (HD) patients with functional iron deficiency (FID) often develop resistance to recombinant human erythropoietin (Epo). The contributory role of chronic inflammation and oxidative stress in its pathogenesis is poorly understood. We assessed the effect of vitamin C, an antioxidant, on Epo-hyporesponsive anemia in hemodialysis patients with un-explained hyperferritinemia levels. Thirty-one of 132 with Hb 15 patients received standard care and 300 mg of intravenous vitamin C with each dialysis session (group 1) and 15 patients received standard care (group 2). After 3 months, Hb and transferrin saturation levels significantly increased in group 1 but not in group 2 (p < 0.05%). Hemoglobin content in reticulocyte and serum ferritin decreased significantly in group 1 but not in control group. In conclusion, hemodialysis patients with refractory anemia and adequate iron stores, vitamin C improved responsiveness to Epo by augmenting iron mobilization and possibly via antioxidant effect.
患有功能性缺铁（FID）的血液透析（HD）患者常常对重组人促红细胞生成素（Epo）产生抵抗。慢性炎症和氧化应激在其发病机制中的作用尚不清楚。我们评估了抗氧化剂维生素C对不明原因高铁蛋白血症水平的血液透析患者中Epo低反应性贫血的影响。132例血红蛋白低于15的患者中，31例患者接受标准护理，每次透析时静脉注射300mg维生素C（第1组），15例患者接受标准护理（第2组）。3个月后，第1组的血红蛋白和转铁蛋白饱和度水平显著升高，而第2组则未升高（p<0.05%）。第1组网织红细胞中的血红蛋白含量和血清铁蛋白显著下降，而对照组则未下降。总之，对于难治性贫血且铁储备充足的血液透析患者，维生素C通过增强铁动员并可能通过抗氧化作用改善了对Epo的反应性。
