Is Vitamin C Intake too Low in Dialysis Patients?
Article first published online: 29 OCT 2012
© 2012 Wiley Periodicals, Inc.
Seminars in Dialysis
Volume 26, Issue 1, pages 1–5, January/February 2013
How to Cite
Raimann, J. G., Levin, N. W., Craig, R. G., Sirover, W., Kotanko, P. and Handelman, G. (2013), Is Vitamin C Intake too Low in Dialysis Patients?. Seminars in Dialysis, 26: 1–5. doi: 10.1111/sdi.12030
- Issue published online: 24 JAN 2013
- Article first published online: 29 OCT 2012
Vitamin C has several well-established roles in physiology including synthesis of collagen, carnitine and epinephrine, absorption of dietary iron, and mobilization of storage iron for erythropoeisis. Loss of several of these functions explains the pathology of scurvy, where defective collagen synthesis and anemia are major symptoms. Vitamin C deficiency is very common in dialysis patients and may arise from dialytic vitamin C clearance, restricted intake of vitamin C-rich foods, and increased vitamin C catabolism in vivo from inflammation. In the dialysis population, greater vitamin C intake may be needed for optimal health. Relationships between intake, body distribution, inflammation, and dialytic losses are complex and need further study. Concern about vitamin C metabolism leading to accumulation of tissue oxalate has led to the recommendation that vitamin C intake equals, but not exceeds, the intake recommended for the general population. Vitamin C deficiency in dialysis patients may have clinical consequences; a study in Renal Research Institute clinics found an association with periodontal disease. Data also support a role for vitamin C in prevention of dialysis-related anemia. New research questions are proposed in this editorial, with a discussion of strategies to determine the optimal provision of vitamin C for CKD patients.