The safety and efficacy of oral vitamin C administration on erythropoietin dosing requirements in end stage renal disease patients on regular hemodialysis
Abstract
End-stage renal disease (ESRD) on hemodialysis (HD) require EPO for anemia complication. Oxalate increases halts Vit C use. This study assessed the safety and efficacy of oral Vit C in reducing erythropoietin (EPO) requirements in patients with HD. This randomized, open-label trial included 60 ESRD patients on stable HD (≥ 90 days) with hemoglobin (Hgb) 9–11 g/dL, transferrin saturation (TSAT) < 30%, ferritin > 100 µg/L, and stable EPO dose for two months. Patients were randomly assigned to one of three groups: A, control-standard regimen; B, standard regimen plus 250 mg/day Vit C, and C, standard regimen plus 500 mg/day Vit C, all for three months. Monthly assessments included Hgb, serum iron (Fe), TSAT, total iron-binding capacity (TIBC), EPO dose, and serum oxalate. Safety was monitored through oxalate measurements. Vit C groups (B and C) demonstrated significant increases in Hgb, serum Fe, and TSAT, along with significant reductions in TIBC and EPO dose versus group (A), (P < 0.05). The percentage reduction in EPO doses at two and three months was comparable and significant in both the Vit C groups. Serum ferritin decreased over time in the Vit C groups and decreased in the control. Serum oxalate increased significantly in both Vit C groups, with higher levels observed in the 500 mg-group. Oral Vit C in ESRD patients on HD improved Fe use and lowered EPO needed short term. Both Vit C 250 mg and 500 mg were effective, but 500 mg increased oxalates more.
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BibTeX
@article{elbanna2026safety,
title = {{The safety and efficacy of oral vitamin C administration on erythropoietin dosing requirements in end stage renal disease patients on regular hemodialysis}},
author = {Marwa El-banna and Tamer ElSaid and Radwa Maher Elborolossy and Lamia Mohamed El Wakeel},
journal = {Scientific Reports},
year = {2026},
month = nov,
doi = {10.1038/s41598-026-73671-9},
url = {https://www.nature.com/articles/s41598-026-73671-9},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - The safety and efficacy of oral vitamin C administration on erythropoietin dosing requirements in end stage renal disease patients on regular hemodialysis
AU - Marwa El-banna
AU - Tamer ElSaid
AU - Radwa Maher Elborolossy
AU - Lamia Mohamed El Wakeel
PY - 2026
DA - 2026/11/02
JO - Scientific Reports
DO - 10.1038/s41598-026-73671-9
UR - https://www.nature.com/articles/s41598-026-73671-9
AB - End-stage renal disease (ESRD) on hemodialysis (HD) require EPO for anemia complication. Oxalate increases halts Vit C use. This study assessed the safety and efficacy of oral Vit C in reducing erythropoietin (EPO) requirements in patients with HD. This randomized, open-label trial included 60 ESRD patients on stable HD (≥ 90 days) with hemoglobin (Hgb) 9–11 g/dL, transferrin saturation (TSAT) < 30%, ferritin > 100 µg/L, and stable EPO dose for two months. Patients were randomly assigned to one of three groups: A, control-standard regimen; B, standard regimen plus 250 mg/day Vit C, and C, standard regimen plus 500 mg/day Vit C, all for three months. Monthly assessments included Hgb, serum iron (Fe), TSAT, total iron-binding capacity (TIBC), EPO dose, and serum oxalate. Safety was monitored through oxalate measurements. Vit C groups (B and C) demonstrated significant increases in Hgb, serum Fe, and TSAT, along with significant reductions in TIBC and EPO dose versus group (A), (P < 0.05). The percentage reduction in EPO doses at two and three months was comparable and significant in both the Vit C groups. Serum ferritin decreased over time in the Vit C groups and decreased in the control. Serum oxalate increased significantly in both Vit C groups, with higher levels observed in the 500 mg-group. Oral Vit C in ESRD patients on HD improved Fe use and lowered EPO needed short term. Both Vit C 250 mg and 500 mg were effective, but 500 mg increased oxalates more.
SN - 2045-2322
ER -