Effect of Intra Venous Ascorbic Acid on Hepatic Iron Overload in Prevalent Hemodialysis Patients with Hepatitis C

Abstract

nemia is common in patients with end-stage renal disease (ESRD) and is a risk factor for hospitalization and mortality. It is mainly due to an absolute or relative decrease in erythropoietin (EPO) production by the failing kidney. Several other factors (iron and vitamin deficiency, infection, inflammation, occult blood loss, oxidative stress, inadequate dialysis, and hyperparathyroidism) often contribute to anemia development and reduce response to treatment (Bonomini et al., 2015). Administration of IV iron to hemodialysis (HD) patients complements ESA therapy, helps maintain target hemoglobin levels, and lowers ESA dosing requirements (Provenzano et al., 2009). However, IV iron use requires careful balance between intended clinical effect and uncertain risks of toxicities. Many authors have raised concerns regarding the hazards of IV iron in HD patients (Kamanna et al., 2012). Recent studies demonstrated that dysregulated iron metabolism is a common feature in HD patients and that it may cause progressive atherosclerotic cardiovascular disease through several pathogenic mechanisms, including oxidative stress induction, an increase in suscepti