Convective and diffusive losses of vitamin C during haemodiafiltration session: a contributive factor to oxidative stress in haemodialysis patients

Moréna, Marion; Cristol, Jean‐Paul; Bosc, Jean‐Yves; Tetta, Ciro; Forret, Gilles; Léger, Claude‐Louis; Delcourt, Cécile; Papoz, L; Descomps, Bernard; Canaud, Bernard

doi:10.1093/ndt/17.3.422

Cited by 170 publications

(163 citation statements)

References 26 publications

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“…The lack of an overall beneficial effect of hemodiafiltration on survival might be explained by several factors. First, the positive effect of an increased removal of uremic toxins might be counteracted by the simultaneous loss of essential substances, 14 and/or undesirable side effects of the treatment itself. 15 Second, although the Kaplan-Meier curves did not even show a trend for a better outcome, the intervention period (mean 3.04 years) may have been too short for an effect on survival.…”

Section: Discussionmentioning

confidence: 99%

Effect of Online Hemodiafiltration on All-Cause Mortality and Cardiovascular Outcomes

Grooteman

Dorpel

Bots

et al. 2012

Journal of the American Society of Nephrology

460

423

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In patients with ESRD, the effects of online hemodiafiltration on all-cause mortality and cardiovascular events are unclear. In this prospective study, we randomly assigned 714 chronic hemodialysis patients to online postdilution hemodiafiltration (n=358) or to continue low-flux hemodialysis (n=356). The primary outcome measure was all-cause mortality. The main secondary endpoint was a composite of major cardiovascular events, including death from cardiovascular causes, nonfatal myocardial infarction, nonfatal stroke, therapeutic coronary intervention, therapeutic carotid intervention, vascular intervention, or amputation. After a mean 3.0 years of follow-up (range, 0.4-6.6 years), we did not detect a significant difference between treatment groups with regard to all-cause mortality (121 versus 127 deaths per 1000 person-years in the online hemodiafiltration and low-flux hemodialysis groups, respectively; hazard ratio, 0.95; 95% confidence interval, 0.75-1.20). The incidences of cardiovascular events were 127 and 116 per 1000 person-years, respectively (hazard ratio, 1.07; 95% confidence interval, 0.83-1.39). Receiving highvolume hemodiafiltration during the trial associated with lower all-cause mortality, a finding that persisted after adjusting for potential confounders and dialysis facility. In conclusion, this trial did not detect a beneficial effect of hemodiafiltration on all-cause mortality and cardiovascular events compared with low-flux hemodialysis. On-treatment analysis suggests the possibility of a survival benefit among patients who receive high-volume hemodiafiltration, although this subgroup finding requires confirmation.

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Section: Discussionmentioning

confidence: 99%

Effect of Online Hemodiafiltration on All-Cause Mortality and Cardiovascular Outcomes

Grooteman

Dorpel

Bots

et al. 2012

Journal of the American Society of Nephrology

460

423

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“…It is known that the increasing OS in patients with CRF on HD can be an aggravating factor in the development of atherosclerosis, which is responsible for the high rate of morbidity and mortality among these patients [18]. OS is usually associated with inflammation in patients with end-stage renal disease (ESRD) in injured tissues, such as the inflammation related to reacting to invading microorganisms [19].…”

Section: Discussionmentioning

confidence: 99%

Oxidative stress: A comparison of different groups of patients with Hepatitis-C in hemodialysis units

Nmo¹,

Ac²,

Bm³

et al. 2015

clinical-practice

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“…Of course, the same is also true for oral ascorbate therapy. Subclinical vitamin C deficiency is frequently encountered in chronic HD patients as a result of insufficient intake from diet (33) and loss during dialytic procedures (34). Tissue concentration of ascorbic acid is further decreased in HD patients, perhaps as a result of increased vitamin oxidation catalyzed by the exaggerated oxidative stress and iron-overloaded states (35,36).…”

Section: Discussionmentioning

confidence: 99%

Effect of Intravenous Ascorbic Acid Medication on Serum Levels of Soluble Transferrin Receptor in Hemodialysis Patients

Tarng

Hung

Huang

2004

Journal of the American Society of Nephrology

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Abstract. Intravenous ascorbic acid (IVAA) medication has been shown to facilitate iron release from inert depots and subsequently circumvent the defective iron utilization in chronic hemodialysis (HD) patients who are treated with recombinant human erythropoietin (rHuEPO). This study focuses on the effects of IVAA supplementation on serum concentrations of soluble transferrin receptors (TfR) on the basis of the hypothesis that an increase of labile iron in the cytosol will lead to inhibition of TfR expression. First, 138 HD patients were studied to evaluate the interrelation between serum TfR and iron status. In a stepwise multivariate analysis, serum EPO and transferrin saturation (TSAT) were the two independent predictors for serum TfR in HD patients (r 2 ϭ 0.510, P Ͻ 0.001). Further analyses showed that the lower the serum EPO and the higher the TSAT, the lower the serum TfR in HD patients who are on maintenance rHuEPO treatment. Second, 36 HD patients were recruited in a randomized, controlled study to receive IVAA (total dose of 2000 mg) or normal saline (placebo) medication. Serum levels of TfR, EPO, and ferritin and TSAT were measured at baseline and within 7 d after starting IVAA or placebo. There were no significant changes in serum EPO and ferritin levels in patients who received either IVAA (n ϭ 18) or placebo (n ϭ 18). Serum TfR levels (P Ͻ 0.001) significantly declined with a parallel rise in TSAT (P Ͻ 0.05) as compared with presupplemental values within 7 d in IVAA patients before any apparent alteration in hematocrit values, but the changes were not observed in the placebo group. The trend of decreased serum TfR and increased TSAT was similar in IVAA patients with ferritin of Ͻ500 g/L or Ͼ500 g/L. It is concluded that ascorbic acid status can significantly decrease serum TfR concentrations and increase percentage of TSAT, probably through alterations in intracellular iron metabolism.

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Convective and diffusive losses of vitamin C during haemodiafiltration session: a contributive factor to oxidative stress in haemodialysis patients

Abstract: These results suggest that HDF with highly permeable membranes is associated with a significant loss of vit C. Diffusive transport is responsible for two-thirds whereas convective phenomenon accounts for only one-third of this loss.

Cited by 170 publications

References 26 publications

Effect of Online Hemodiafiltration on All-Cause Mortality and Cardiovascular Outcomes

Effect of Online Hemodiafiltration on All-Cause Mortality and Cardiovascular Outcomes

Oxidative stress: A comparison of different groups of patients with Hepatitis-C in hemodialysis units

Effect of Intravenous Ascorbic Acid Medication on Serum Levels of Soluble Transferrin Receptor in Hemodialysis Patients

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