Paper

Vitamin C Neglect in Hemodialysis: Sailing between Scylla and Charybdis
Garry J. Handelman

Renal Research Institute, New York, N.Y., USA

Address of Corresponding Author

Blood Purif 2007;25:58-61 (DOI: 10.1159/000096399)

  Key Words

• Vitamin C
• Hemodialysis
• Oxalosis, systemic

  Abstract

In our efforts to meet the vitamin C requirements of dialysis patients we confront a medical dilemma - do we allow the patient to become depleted of vitamin C, with the accompanying hematological and other consequences (Scylla), or do we provide for adequate tissue levels of vitamin C, which has been thought to carry the risk of oxalosis (Charybdis). Many practitioners are certain that either one outcome (deficiency) or the other (oxalic acid toxicity) is inevitable, and much like Odysseus, no safe course is to be found. The recent accumulating evidence that vitamin C improves the management of anemia in dialysis patients compels us to find a safe passage through this dilemma. The serious vitamin C deficiency seen in many patients may also contribute to poor oral health and chronic fatigue. The evidence for oxalosis from vitamin C supplements stems from hemodialysis as practiced 20 years ago. Investigators using this therapy are not observing systemic oxalosis, and the most current data support the conclusion that vitamin C therapy is safe for dialysis patients. The question will be resolved by controlled trials that address both vitamin C effectiveness and safety.

Copyright © 2007 S. Karger AG, Basel

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  Author Contacts

Garry J. Handelman
Renal Research Institute
207 E. 94th Street, Suite 303
New York, NY 10128 (USA)
Tel. +1 646 672 4042, Fax +1 646 672 4174, E-Mail ghandelman@rriny.com

  Article Information

Published online: December 14, 2006
Number of Print Pages : 4
Number of Figures : 0, Number of Tables : 0, Number of References : 39

  Publication Details

Blood Purification

Vol. 25, No. 1, Year 2007 (Cover Date: December 2006)

Journal Editor: Leunissen, K.M.L. (Maastricht)
ISSN: 0253-5068 (print), 1421-9735 (Online)

For additional information: http://www.karger.com/BPU

  Drug Dosage / Copyright

Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.