Abstract

ALFARO CUENCA, Antonia; SANDOVAL ORTIZ, Ana; CEBRIAN SALAS, Eva Mª  and  RUIZ DE SAN MARTIN, Marisol. The efficacy of the administration of ascorbic acid in haemodialysis patients under treatment with darbepoetine and a functional iron deficit. Rev Soc Esp Enferm Nefrol [online]. 2005, vol.8, n.2, pp.109-114. ISSN 1139-1375.

Functional iron deficit is a well-known cause of hyporeply to treatment with erithropoyetic stimulator in anemia in patients under haemodialysis. The objective of our study is to evaluate the efficacy of the intravenous administration of ascorbic acid in patients with functional ferropoenia receiving treatment with darbepoetine. We include 33 patients in conventional haemodialysis for more than six months and treated with darbepoetine, who show ferritine figures of more than 350 ng/ml and a transferrine saturation index of under 25%. These patients are administered ascorbic acid intravenously after haemodialysis (300 mg three times a week) for 12 weeks. A base control was performed after 2, 4, 6, 8, 10 and 12 weeks and 15 days after treatment is complete, of haemoglobin, hematocrite, ferritine, IST, blood iron, transferrine, darbepoetine dose, uric acid, PCR and blood vitamin C. 26 patients complete the study (50% women). The average age is 66.81 (range 26-85). They have been under haemodialysis for 46.19 months (range 7-192). The haemoglobin levels increase progressively throughout the study, significantly after 12 weeks of treatment (base 11.72; final 12.75, p 0.005). The administered dose of darbepoetine falls, but not significantly (base 38.27; final 32.70). The iron status improves during the study. The blood iron and the IST increase significantly (p=0.017 and p=0.001, respectively). The ferritin levels fall and those of transferrine increase, in both cases without statistical significance. The plasma levels of vitamin C can not be detected at the begining of the study and reach maximum levels after 6 weeks of treatment (0.48 ± 0.31). The administration of ascorbic acid is useful as a coadjuvant in anaemia, as it significantly increases the haemoglobin levels and iron bioavailability, partly reducing the tissue deposits.

Keywords : Ascorbic acid; Renal anaemia; Darbepoetine; Iron deficit.

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