Vitamin C deficiency and impact of vitamin C administration among pediatric patients with advanced chronic kidney disease
| Autor: | Konggrapun Srisuwan, Parach Vittayananan, Nattaphorn Hongsawong, Notethasoung Chawprang, Kulnipa Kittisakmontri, Wattana Chartapisak |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Nephrology
medicine.medical_specialty Adolescent medicine.medical_treatment 030232 urology & nephrology Ascorbic Acid 030204 cardiovascular system & hematology Gastroenterology 03 medical and health sciences 0302 clinical medicine Renal Dialysis Internal medicine medicine Prevalence Humans Prospective Studies Vitamin C deficiency Renal Insufficiency Chronic Vitamin D Prospective cohort study Child Dialysis Oxalates Vitamin C business.industry Vitamins Anthropometry medicine.disease Vitamin D Deficiency Pediatrics Perinatology and Child Health Ascorbic Acid Deficiency Hemoglobin business Kidney disease |
| Zdroj: | Pediatric nephrology (Berlin, Germany). 36(2) |
| ISSN: | 1432-198X |
| Popis: | Vitamin C deficiency is common in chronic kidney disease (CKD) due to losses through dialysis and dietary intake below requirement. We investigated prevalence of vitamin C deficiency and impact of vitamin C treatment in deficient/insufficient patients.A prospective cohort study in patients aged 1-18 years with CKD stages 4 and 5D collected demographic data including underlying disease, treatment, and anthropometric assessment. Vitamin C intake was assessed using 24-h dietary recall. Hemoglobin, iron status, serum vitamin C, and serum oxalate were measured at baseline and after treatment. Vitamin C (250 mg/day) was given orally for 3 months to deficient/insufficient patients.Nineteen patients (mean age 12.00 ± 4.1 years) showed prevalence of 10.6% vitamin C insufficiency and 78.9% deficiency. There were no associations between vitamin C level and daily vitamin C intake (p = 0.64) or nutritional status (p = 0.87). Median serum vitamin C was 1.51 (0.30-1.90) mg/L. In 16 patients receiving treatment, median serum vitamin C increased from 1.30 (0.23-1.78) to 3.22 (1.77-5.96) mg/L (p = 0.008) without increasing serum oxalate (79.92 (56.6-106.84) vs. 80.47 (56.88-102.95) μmol/L, p = 0.82). However, 62.5% failed to achieve normal vitamin C levels. Ordinal regression analysis revealed patients with non-oligoanuric CKD were less likely to achieve normal vitamin C levels (β = - 3.41, p = 0.03).We describe high prevalence of vitamin C insufficiency/deficiency among pediatric CKD patients. Vitamin C levels could not be solely predicted by nutritional status or daily intake. The treatment regimen raised serum vitamin C without increasing serum oxalate; however, it was largely insufficient to normalize levels, particularly in non-oligoanuric CKD. Graphical abstract . |
| Databáze: | OpenAIRE |
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