P1599USE OF ASCORBATE-RICH DIALYSATE IN HEMODIALYSIS PATIENTS

Abstract

Abstract Background and Aims Increments of oxidative stress have been addressed as one potential cause for the accelerated atherosclerosis of chronic kidney disease patients. Ascorbate (vitamin-C) represents one of the most prominent antioxidants both in plasma and intracellulary. Unsupplemented dialysis patients have reportedly lower plasma levels of ascorbate in comparison to healthy controls, mostly due to a loss into the dialysate. Purpose of our study was the recording of the experience of the use of Ascorbate-Rich Dialysate in patients under hemodialysis (HD). Method 11 HD patients were recruited for the study. During a period of 8 weeks they were receiving Ascorbate-Rich Dialysate (2g/lt). Ascorbic acid levels were estimated before and at the end of the study period. We also monitored patients’ anemia profile (Hb, Hct, ferritin, TSAT, rhEPO dose), lipid and nutrition status. Results Ascorbic acid values were towards the lower accepted levels in our patients (3.25±1.01 mg/l) at the beginning of the study period. After 8 weeks receiving Ascorbate-Rich Dialysate, acorbic-acid levels were significantly increased (6.87±1.50 mg/l) without transcending the upper accepted limit. During the notice period, our patients were behaved normally without any sort of adverse events. Mean Hct levels remained stable (39.10±3.70% with conventional dialysate vs 39.67±1.59 % with usage of ascorbate-rich dialysate ). The same conclusion was noticed with Hb levels (12.85±1.20 vs 13.15±0.49). Mean rhEPO dose per week (epoetin- alfa) decreased (9000±5200 iu vs 6250±4300 iu, p=NS) and administration of Fe stopped to all of our patients. Ferritin (>700), TSAT (>35) remained stable over the whole study period. Cholesterol, triglycerides and albumin levels did not change significantly with the change of the conventional dialysate to ascorbic-rich one. Conclusion Although our study is limited by small numbers of subjects, short durations of follow-up, our results suggest that compared with standard care, ascorbic acid in dialysate bath is a safe choice to increase ascorbic-acid levels in traditionally vitamic C depleted HD patients within safe limits. This raise seems to favors anemia profile of HD population. Longer term studies are required to confirm these results, determine whether these changes translate into improved patient outcomes and cost-effectiveness.