K Vignesh Babu, Rajh Bharath
Biochemistry, Arunai Medical College and Hospital, Tiruvannamalai, IND.
Community Medicine, Velammal Medical College Hospital & Research Institute, Madurai, IND.
Cureus. 2025 May 4;17(5):e83480. doi: 10.7759/cureus.83480. eCollection 2025 May.
Chronic kidney disease (CKD) is a condition where there is a progressive decline in kidney function, which is characterized by an estimated glomerular filtration rate of less than 60 mL/min/1.73 m². Vitamin C is a strong antioxidant, and pentraxin 3 (PTX3) is an early reliable sign of vascular inflammation and cardiovascular risk. However, it is still not clear how these two markers interact with each other during hemodialysis. This study aimed to correlate vitamin C and pentraxin-3 levels pre- and post-dialysis among CKD patients.
A prospective observational study was conducted at Dhanalakshmi Srinivasan Medical College and Hospital, involving 60 CKD patients aged more than 18 years who were on maintenance hemodialysis. After obtaining written informed consent, we collected the participants' demographic information, clinical data, and biochemical parameters from their medical records. We used high-performance liquid chromatography (HPLC) and enzyme-linked immunosorbent assay (ELISA) to check the levels of vitamin C and PTX3 in the blood sample taken 30 minutes before and after dialysis. Vitamin C levels were classified as deficient, low, or normal, and pentraxin 3 values were categorized as normal, mildly elevated, moderately elevated, and severely elevated. A paired t-test was used to assess pre- and post-dialysis variations among the blood biochemical parameters. Pearson's correlation analysis was done to determine the correlation between vitamin C and pentraxin 3 in hemodialysis patients.
The study population had a mean age of 52.88 ± 9.55 years, with 51 (85%) males. Vitamin C levels dropped significantly after dialysis from 0.24 ± 0.092 mg/dL to 0.19 ± 0.085 mg/dL (p = 0.001), but PTX3 levels increased from 4.64 ± 1.299 ng/mL to 6.63 ± 1.259 ng/mL (p = 0.001) after dialysis. A total of 40 (66.67%) study participants were found to have low vitamin C levels; vitamin C deficiency was present in 19 (31.67%) participants in a pre-dialysis state, and their condition worsened further post-dialysis. A total of 31 (51.67%) participants had severely elevated PTX 3 levels, which further increased post-dialysis. PTX3 levels were consistently higher in hypertensive and diabetic patients, highlighting the inflammatory burden in these populations. There exists a weak, nonsignificant negative correlation between vitamin C and PTX 3 levels both pre- (r = -0.137, p = 0.781) and post-dialysis (r = -0.141, p= 0.757).
Although this observational study cannot establish causality, it indicates that hemodialysis is associated with reduced antioxidant levels and increased inflammatory markers. These findings suggest a possible link between oxidative stress and inflammation in CKD patients. Further studies are needed to evaluate the therapeutic role of antioxidant supplementation in mitigating cardiovascular risks.
慢性肾脏病（CKD）是一种肾功能逐渐下降的病症，其特征为估计肾小球滤过率低于60 mL/分钟/1.73平方米。维生素C是一种强大的抗氧化剂，而五聚素3（PTX3）是血管炎症和心血管风险的早期可靠指标。然而，目前仍不清楚这两种标志物在血液透析过程中是如何相互作用的。本研究旨在关联CKD患者透析前后的维生素C和五聚素3水平。
在达纳拉克希米·斯里尼瓦桑医学院和医院进行了一项前瞻性观察研究，纳入60名年龄超过18岁且正在接受维持性血液透析的CKD患者。在获得书面知情同意后，我们从参与者的病历中收集了他们的人口统计学信息、临床数据和生化参数。我们使用高效液相色谱法（HPLC）和酶联免疫吸附测定法（ELISA）检测透析前30分钟和透析后采集的血样中维生素C和PTX3的水平。维生素C水平分为缺乏、低或正常，五聚素3值分为正常、轻度升高、中度升高和重度升高。采用配对t检验评估血液生化参数透析前后的变化。进行Pearson相关分析以确定血液透析患者中维生素C和五聚素3之间的相关性。
研究人群的平均年龄为52.88±9.55岁，其中51名（85%）为男性。透析后维生素C水平从0.24±0.092毫克/分升降至0.19±0.085毫克/分升，差异有统计学意义（p = 0.001），但透析后PTX3水平从4.64±1.299纳克/毫升升至6.63±1.259纳克/毫升（p = 0.001）。共有40名（66.67%）研究参与者维生素C水平较低；19名（31.67%）参与者在透析前存在维生素C缺乏，透析后情况进一步恶化。共有31名（51.67%）参与者PTX 3水平重度升高，透析后进一步升高。高血压和糖尿病患者的PTX3水平始终较高，突出了这些人群的炎症负担。维生素C和PTX 3水平在透析前（r = -0.137，p = 0.781）和透析后（r = -0.141，p = 0.757）均存在微弱的、无统计学意义的负相关。
尽管这项观察性研究无法确定因果关系，但它表明血液透析与抗氧化剂水平降低和炎症标志物升高有关。这些发现提示CKD患者氧化应激与炎症之间可能存在联系。需要进一步研究评估补充抗氧化剂在减轻心血管风险方面的治疗作用。
