The Protective Effect of Vitamin C Targeting Oxidative Stress on Renal Function in Patients with Septic Acute Kidney Injury: A Prospective, Randomized Controlled, Pilot Study

Objective: To explore whether vitamin C supplementation in sepsis patients can reduce the occurrence of acute kidney injury. Methods: A prospective, randomized and controlled pilot trial was conducted. All individuals participating in the study received comprehensive initial treatment for sepsis. This involved monitoring lactate levels, ensuring appropriate fluid resuscitation, administering empiric broad-spectrum antibiotics, and using vasoactive medications, with a preference for norepinephrine. If the norepinephrine dosage exceeded 20 μg/min, vasopressin was introduced at a rate of 0.03 U/min to sustain a mean arterial pressure of at least 65 mmHg. The experimental group was given vitamin C (1.5 g every 6 h by intravenous infusion) for 3 consecutive days, while the control group was given placebo. Results: A total of 40 patients with sepsis were included in the study following application of the inclusion and exclusion criteria. Patients were randomized into control (n = 20) and experimental (n = 20) groups. No significant differences in baseline characteristics were found between the two groups (all p > 0.05). Among the 40 sepsis patients, 5 (25%) in the experimental group and 14 (70%) in the control group developed acute kidney injury, all of whom required support with continuous renal replacement therapy (RRT). The main site of infection was pulmonary, accounting for 70% of cases in the experimental group and 75% in the control group. The most common pathogenic bacteria were gram-negative bacilli (26/40, 65%). The experimental group had a significantly shorter length of stay in intensive care unit (ICU) compared to the control group (11.8 ± 2.7 days vs. 13.9 ± 2.1 days, p = 0.008), less frequent use of vasoactive drugs (35% vs. 75%, p = 0.011), and less frequent need for RRT within 72 h of admission (25% vs. 70%, p = 0.004). However, the mortality rate in ICU was not significantly different (10% vs. 15%, p = 0.633). Conclusion: The use of vitamin C in patients with sepsis is associated with a reduced incidence of acute kidney injury, although a larger sample size is required to confirm this finding. Clinical Trial Registration: This trial was registered at Chinese Clinical Trial Registry (ChiCTR2400093794, https://www.chictr.org.cn/hvshowproject.html?id=265499&v=1.0).