Efficacy and safety of oral versus intravenous ascorbic acid for anaemia in haemodialysis patients

SUMMARY: Background: Intravenous (i.v.) ascorbic acid (AA) improves anaemia in iron-overloaded, erythropoietin (rEPO) hyporesponsive haemodialysis patients. While oral AA is readily attainable, the efficacy and safety of oral versus i.v. AA has not been examined. Methods: We conducted an open-label randomised parallel study on the effects of 8 weeks of 250 mg oral AA (n = 10) compared with 250 mg i.v. AA (n = 11) 3×/week on haemoglobin (Hb), ferritin and rEPO dose in 21 iron-overloaded haemodialysis patients. We also examined the effect of 3 months of 500 mg oral AA 3×/week (n = 70) compared with no treatment (n = 83) on Hb, ferritin and rEPO dose in 153 haemodialysis patients. Results: Patients had severe AA deficiency (mean 2.2 ± SE 0.4 mg/L; normal range, 4.0–14.0). Following treatment, the plasma AA level increased (P