No Reported Renal Stones with Intravenous Vitamin C Administration: A Prospective Case Series Study

Melissa Prier,Anitra Carr,Nicola Baillie

doi:10.3390/antiox7050068

Melissa Prier, Anitra Carr + Show 1 more

Open Access

https://doi.org/10.3390/antiox7050068

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Journal: Antioxidants	Publication Date: May 21, 2018
Citations: 20	License type: CC BY 4.0

Affiliation: University of Otago, Auckland District Health Board

Abstract

A few cases associating high dose intravenous vitamin C (IVC) administration with renal stone formation have been reported in the literature, however, no long-term studies investigating IVC administration and reported renal stones have been carried out. Our aim was to measure the frequency of reported renal stones in patients receiving IVC therapy. We carried out a prospective case series study of 157 adult patients who commenced IVC therapy at Integrated Health Options clinic between 1 September 2011 and 31 August 2012, with follow-up for 12 months. Inquiries into the occurrence of renal stones were conducted at enrolment, 6 and 12 months, and renal function blood tests were conducted at enrolment, 4 weeks and every 12 weeks thereafter in a subgroup of patients. No renal stones were reported by any patients in the study, despite 8% of the patients having a history of renal stones. In addition, the majority of patients investigated had stable renal function during the study period as evidenced by little change in serum creatinine levels and estimated glomerular filtration rate (eGFR) following IVC. In conclusion, IVC therapy was not associated with patient-reported renal stones. Although not the primary focus of this study, it was also observed that there was no significant change in mean serum creatinine or eGFR for those who had follow-up renal function blood tests.

Highlights

Intravenous vitamin C (IVC) has been used for many decades by health care practitioners for a number of indications, cancer and infection [1,2,3]
Pharmacokinetic studies have found that the peak concentration of vitamin C achievable in blood plasma following oral ingestion is about 220 μmol/L, whereas at least 15 mmol/L is achievable following IVC administration [7]
Patient characteristics are presented in Table 1; it should be noted that 12 (8%) of the patients had a history of renal stones

Summary

Introduction

Intravenous vitamin C (IVC) has been used for many decades by health care practitioners for a number of indications, cancer and infection [1,2,3]. Recent studies indicate that IVC can improve the outcomes of patients with severe infections and burns, and improve post-surgical recovery [5,6]. Pharmacokinetic studies have found that the peak concentration of vitamin C achievable in blood plasma following oral ingestion is about 220 μmol/L, whereas at least 15 mmol/L is achievable following IVC administration [7]. One of the proposed mechanisms of IVC is to target cancer cells via an indirect pro-oxidant mechanism relying on transition metal ion-dependent generation of hydrogen peroxide; vitamin C must be injected intravenously in order to achieve sufficiently high plasma vitamin. Lower IVC doses tend to be used for patients with severe infection with the proposed mechanism of IVC being primarily support of organ and immune function [5,11]

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