Ascorbic Acid Aggravates Secondary Hyperoxalemia in Patients on Chronic Hemodialysis

Brief Reports1 September 1984Ascorbic Acid Aggravates Secondary Hyperoxalemia in Patients on Chronic HemodialysisPETER BALCKE, M.D., PAUL SCHMIDT, M.D., JAN ZAZGORNIK, M.D., HERBERT KOPSA, M.D., ALEXANDER HAUBENSTOCK, M.D.PETER BALCKE, M.D., PAUL SCHMIDT, M.D., JAN ZAZGORNIK, M.D., HERBERT KOPSA, M.D., ALEXANDER HAUBENSTOCK, M.D.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-101-3-344 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptA deficiency in ascorbic acid is found in many patients having chronic hemodialysis treatment, and supplementation is commonly recommended. Ascorbic acid is a metabolic precursor of oxalic acid. Because this compound accumulates during chronic renal insufficiency (1), the administration of ascorbic acid could cause a further increase of plasma oxalic acid levels in patients on chronic hemodialysis.Over a period of 4 weeks, nine patients on chronic hemodialysis (seven men, two women; mean age, 41 years) received 1 g of ascorbic acid intravenously after each dialysis session, or a total dose of 12 g for each patient. The clinical diagnosis...References1. BALCKESCHMIDTZAZGORNIKKOPSADEUTSCH PPJHE. Secondary oxalosis in chronic renal insufficiency [Letter]. N Engl J Med. 1980;303:944. CrossrefMedlineGoogle Scholar2. KRUGERS DAGNEAUXKLEIN ELHORSTOLTHUIS PJF. Oxalic acid determination in plasma. Clin Chim Acta. 1976;71:319-25. CrossrefMedlineGoogle Scholar3. KASIDASROSE GG. A new enzymatic method for the determination of glycollate in urine and plasma. Clin Chim Acta. 1979;96:25-36. CrossrefMedlineGoogle Scholar4. PRUEATONKJELLSTRAND CJC. Vitamin C may cause secondary oxalosis in chronic hemodialysis patients [Abstract]. Kidney Int. 1982;21:176. Google Scholar5. EARNESTJOHNSONWILLIAMSADMIRAND DGHW. Hyperoxaluria in patients with ileal resection: an abnormality in dietary oxalate absorption. Gastroenterology. 1974;66:1114-22. CrossrefMedlineGoogle Scholar6. LAMDENCHRYSTOWSKI MG. Urinary oxalate excretion by man following ascorbic acid ingestion. Proc Soc Exp Biol Med. 1954;85:190-2. CrossrefMedlineGoogle Scholar7. PÖNKÄKUHLBÄCK AB. Serum ascorbic acid in patients undergoing chronic hemodialysis. Acta Med Scand. 1983;213:305-7. CrossrefMedlineGoogle Scholar8. ANGELALFREDLEICHTERLEEMARCHANT JBJML. Effect of oral administration of large quantities of ascorbic acid on blood levels and urinary excretion in healthy men. Int J Vitam Nutr Res. 1975;45:237-43. MedlineGoogle Scholar9. SALYERKEREN WD. Oxalosis as a complication of chronic renal failure. Kidney Int. 1973;4:61-6. CrossrefMedlineGoogle Scholar10. HOFMANNSCHMACHERPAUL GHH. Calcium oxalate microcrystalline-associated arthritis in end-stage renal disease. Ann Intern Med. 1982;97:36-42. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: I. Medizinische Universitatsklinik Vienna Austria. 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