Acute Oxalate Nephropathy After Massive Ascorbic Acid Administration

Lawton, John Mark

doi:10.1001/archinte.1985.00360050220044

Cited by 76 publications

(18 citation statements)

References 14 publications

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“…Informa- tion comes only from case reports of toxicity when patients received relatively large doses of IV vitamin C (500 mg to 60 g). [13][14][15]17 In the present study, a significant increase was observed in mean urinary oxalate excretion of 29.4% after supplementation with vitamin C was increased from 100 to 200 mg IV per day. Traxer et al, 24 evaluating 12 normal subjects and 12 calcium oxalate stone formers after the oral ingestion of 1 g of ascorbic acid for 6 days, found an increase of oxaluria of 20% in normal subjects and 33% in the stone-forming subjects.…”

Section: Patient Demographics Are Depicted Insupporting

confidence: 55%

“…11,12 A series of case reports has also described an association between IV vitamin C and oxalosis. [13][14][15][16][17] Despite newer assays that minimize in vitro conversion of ascorbic acid to oxalate, controversy still remains, with some studies suggesting that vitamin C can increase urinary oxalate excretion, whereas others do not support this pathway as a significant contributor to urinary oxalate. 12 The current recommended dietary allowance for vitamin C is 60 mg/d.…”

Section: Introductionmentioning

confidence: 99%

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Urinary Oxalate Excretion Increases in Home Parenteral Nutrition Patients on a Higher Intravenous Ascorbic Acid Dose

Vega¹,

Lieske²,

Milliner³

et al. 2004

J Parenter Enteral Nutr

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Section: Patient Demographics Are Depicted Insupporting

confidence: 55%

Section: Introductionmentioning

confidence: 99%

Urinary Oxalate Excretion Increases in Home Parenteral Nutrition Patients on a Higher Intravenous Ascorbic Acid Dose

Vega¹,

Lieske²,

Milliner³

et al. 2004

J Parenter Enteral Nutr

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“…5 High-dose vitamin C has also been implicated in secondary oxalate nephropathy. In 1985, Lawton and colleagues 6 reported a case of secondary oxalate nephropathy after a single administration of 45 g of IV ascorbic acid as an adjuvant therapy for primary amyloidosis with nephrotic syndrome. Clinical presentation can be nonspecific with AKI and hematuria.…”

Section: Discussionmentioning

confidence: 99%

Collapsing Focal Segmental Glomerulosclerosis and Acute Oxalate Nephropathy in a Patient With COVID-19: A Double Whammy

Malhotra

Magoon

Troyer

et al. 2020

Journal of Investigative Medicine High Impact Case Reports

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As COVID-19 (coronavirus disease 2019) spreads across the world multiple therapeutic interventions have been tried to reduce morbidity and mortality. We describe a case of collapsing focal sclerosing glomerulosclerosis (FSGS) and acute oxalate nephropathy in a patient treated with high-dose intravenous vitamin C for severe COVID-19 infection. Collapsing FSGS has been described in patients with COVID-19 infection associated with APOL-1; however, this case had collapsing FSGS developing in low-risk heterozygous APOL-1 variant, and we postulate that the intensity of the COVID-19 cytokine storm overwhelmed the protective state of APOL-1 heterozygosity. This case illustrates the importance of assessing the risk and benefit of planned therapeutic interventions on a case-by-case basis especially when there are still so many unknowns in the management of COVID-19 infection. Strong consideration should be given for performing a renal biopsy in patients who develop multifactorial acute kidney injury.

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“…Subsequent studies and metanalyses have not been [6][7][8] . Although commonly regarded as relatively innocuous, high-dose morbidity and mortality [9][10][11][12][13][14][15] . A fatal outcome associated with apparent excessive vitamin C supplementation is reported here.…”

mentioning

confidence: 99%

Fatal Vitamin C-associated Acute Renal Failure

Freebairn

2008

Anaesth Intensive Care

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Although daily ingestion of high-dose vitamin C is generally regarded as largely innocuous, fatal nephrotoxicity can occur in some rare circumstances. We report a case where the patient, who chose to forgo any advanced conventional medical intervention (dialysis and mechanical ventilation), had failed to disclose his use of high-dose vitamin C and subsequently died. Intra-renal oxalate crystal deposition was demonstrated at autopsy. Directed enquiry with the family then revealed his high-dose vitamin C usage. Even though fully-informed discussion was limited by incomplete prospective disclosure, it remains the prerogative of any competent patient to decline any treatment, including those that may be considered life-saving.

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Acute Oxalate Nephropathy After Massive Ascorbic Acid Administration

Cited by 76 publications

References 14 publications

Urinary Oxalate Excretion Increases in Home Parenteral Nutrition Patients on a Higher Intravenous Ascorbic Acid Dose

Urinary Oxalate Excretion Increases in Home Parenteral Nutrition Patients on a Higher Intravenous Ascorbic Acid Dose

Collapsing Focal Segmental Glomerulosclerosis and Acute Oxalate Nephropathy in a Patient With COVID-19: A Double Whammy

Fatal Vitamin C-associated Acute Renal Failure

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