大剂量维生素C对COVID-19患者肾功能的影响

Asu Özgültekin, A. Karayel, Seher Yanatma, O. Ekinci
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摘要

背景:维生素C具有重要的特性,已被用于治疗多种疾病和败血症。COVID-19可能导致败血症,因此高剂量维生素C已被纳入治疗方案。针对长期或高剂量维生素C使用与草酸肾病的潜在风险,我们回顾性评估了高剂量静脉注射维生素C治疗的COVID-19患者的肾功能障碍。材料与方法:比较重症COVID-19患者在ICU住院15 d内,给予维生素C 45-50 gr/d /5 d (C组,n=21)与未给予维生素C 45-50 gr/d (NC组,n=22)并给予羟氯喹-法匹拉韦治疗的肾功能损害情况。结果:服用维生素C组与未服用维生素C组肾功能不全情况无显著差异(p>0.05)。但当排除入院时已发生KDIGO期肾损害、ICU住院期间肾功能恶化的患者时,患者组更相似,维生素C组肾功能衰竭的发生明显多于对照组(p<0.05)。结论:我们得出结论,在给予高剂量静脉注射维生素C时,应仔细评估肾功能。
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The effect of high-dose vitamin C on renal functions in COVID–19 patients
  Background: With its important properties, Vitamin C has been used in several diseases and sepsis. COVID-19 may cause sepsis, and therefore high dose Vitamin C has been integrated to the treatment protocols.Concerning the potential risk of oxalate nephropaty related with the use of long term or high dose Vitamin C, we retrospectively evaluated the COVID-19 patients treated with the high dose intravenous Vitamin C, in terms of kidney dysfunction. Material and Method: Critically ill COVID-19 patients who were given Vitamin C 45-50 gr/day/5 days (Group C, n=21), and the ones who did not (Group NC, n=22) along with the hydroxychloroquine- favipiravir treatment were compared in terms of developing renal dysfunction within the 15 days of ICU stay. Results: There were no difference in the development of renal dysfunction between the groups with and without Vitamin C treatment (p>0.05). But when the patients who had KDIGO stage 1 kidney damage on admission, and had worsening renal dysfunction during ICU stay were excluded, patients groups were more similar and the development of the renal failure was significantly more in Vitamin C group(p<0.05). Conclusion: We conclude that when administering high dose parenteral Vitamin C, kidney functions should be carefully assessed.
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