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Submitted: 17 Jun 2021
Accepted: 02 Aug 2021
ePublished: 14 Aug 2021
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J Renal Endocrinol. 2021;7(1): e16.
doi: 10.34172/jre.2021.16
  Abstract View: 169
  PDF Download: 101

Original Article

Effect of oral vitamin C on serum hepcidin level, iron status and inflammation among hemodialysis patients with functional iron deficiency anaemia

Maha A. Behairy 1* ORCID logo, Ahmed Gharib 1, Mahmoud Zaki 1, Reem El Sharabasy 1 ORCID logo

1 Internal Medicine and Nephrology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
*Corresponding Author: Maha Abdelmoneim Behairy, Email: mahabehairy@med.asu.edu.eg, Mahabehairy80@gmail.com

Abstract

Introduction: Hepcidin is a key regulatory peptide in iron homeostasis, the pathogenesis of functional iron deficiency (FID) anemia and erythropoiesis-stimulating agent (ESA) resistance is contributed to the inflammatory mediated increase in the serum hepcidin levels among prevalent hemodialysis (HD) patients.

Objectives: To test the reducing therapeutic effect of oral vitamin C supplements on hepcidin levels and iron status among HD patients with FID anemia.

Patients and Methods: This study is an interventional prospective cohort study; 48 prevalent HD patients were enrolled. Group one: 31 patients who received the conventional treatment of erythropoietin stimulating agents together with oral supplementation of vitamin C 500 mg every other day dose for 3 months. Group two: 17 patients who received only the conventional therapy of erythropoietin stimulating agents. Patients with hemoglobin level <11 g/dL, ferritin level >200 ng/mL and transferrin saturation (TSAT) >20 % were included. Laboratory parameters: serum hepcidin, high-sensitivity C-reactive protein (hs-CRP) titre, CBC, and iron indices were measured at baseline and after 3 months.

Results: On comparing the two groups, oral vitamin C in group 1 resulted in a statistically significant reduction in hepcidin levels [mean 2506.456 ± 1320.53 pg/mL to 1748.396 ± 1432.28 pg/mL (P = 0.03)], and a significant reduction in hs-CRP level [mean 8603.236 ± 2547.77 ng/mL to 5611.296 ± 2829.27 ng/mL] (P = 0.001) after three months of treatment in comparison to control group. A decrease of EPO requirement and elevation of hemoglobin level were observed in a study group with oral vitamin C.

Conclusion: Oral vitamin C may be a promising therapy in decreasing serum hepcidin and inflammatory markers among prevalent HD patients with FID anemia.

Keywords: Vitamin C, Hemodialysis, Hepcidin, Iron deficiency, Anaemia
Citation: Behairy MA, Gharib A, Zaki M, El Sharabasy R. Effect of oral vitamin C on serum hepcidin level, iron status and inflammation among hemodialysis patients with functional iron deficiency anaemia. J Renal Endocrinol. 2021;7:e16. doi: 10.34172/jre.2021.16.
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