ascorbic-acid and Hyperphosphatemia

In developed countries, colonoscopy volume has increased dramatically over the past 15 years and is the principle method used to screen for colon cancer. Preparations used for colon cleaning have evolved over the past 30 years. Some preparations have been shown to be unsafe and are now used on a limited basis. There has been progress on limiting the volume required and on taste improvement.. This review provides an account of preparations used from 1980 when PEG-based preparations became widely available, until the present day. The review highlights their mechanism of action and principle toxicities. The handling of solutes and solute-free fluid by the colon is also reviewed.. The reader will gain a perspective on the factors considered in developing colonic purgatives and the rationale for choosing selected preparations based on patient factors such as age, co-morbidities and concomitant medications.. Although generally safe and effective, colonic purgatives have both acute and permanent toxicities. The safest preparations utilize PEG combined with a balanced electrolyte solution. Limitations of this preparation center on the volume required and poor taste. Alternative formulations are now available; however, those using sodium phosphate have fallen out of favor due to a risk of renal toxicity.

Topics: Ascorbic Acid; Calcium Phosphates; Cathartics; Citric Acid; Colonic Neoplasms; Colonoscopy; Humans; Hyperphosphatemia; Hypocalcemia; Nephrocalcinosis; Organometallic Compounds; Phosphates; Preoperative Care; Randomized Controlled Trials as Topic; Therapeutic Irrigation

The majority of hemodialysis patients are hyperphosphatemic. Hyperphosphatemia in these patients can lead to renal osteodystrophy, vascular calcification, cardiovascular events, and is independently associated with mortality risk. The aim of this study was to evaluate the effect of intravenous vitamin C on phosphorus level in hemodialysis patients.. Using a double blind randomized clinical trial, a total of 60 qualified hemodialysis patients were randomly allocated in two intervention and control groups and serum phosphorus, CRP, calcium, albumin and PTH levels were measured. At the end of each hemodialysis session, intervention group received vitamin C vial (500 mg/5 cc) intravenously three times a week for 8 weeks and control group received normal saline in the same way. Data were collected before and after two months of treatment. Data were analyzed using independent t-test, paired t-test and chi-square test.. Vitamin C treated group had a significant decrease in phosphorus (p=0.01), CRP level (p=0.01) and Ca×P product (p=0.03). In contrast, there was no significant difference in phosphorous (p= 0.5) and CRP levels (p= 0.6) and Ca×P product (p=0.7) in the control group. In addition, there was no statistically significant change in calcium (p=0.1), PTH (p=0.4) and albumin (p=0.4) levels in both groups.. Intravenous vitamin C can significantly decrease phosphorus level in hemodialysis patients.

Topics: Adult; Aged; Ascorbic Acid; C-Reactive Protein; Calcium; Double-Blind Method; Female; Humans; Hyperphosphatemia; Infusions, Intravenous; Male; Middle Aged; Phosphorus; Renal Dialysis; Young Adult