ascorbic-acid and Kidney-Tubular-Necrosis--Acute

Vitamin C deficiency is found in patients with variable kidney diseases. However, the role of vitamin C as an epigenetic regulator in renal homeostasis and pathogenesis remains largely unknown.. Integrated evidence suggested that epigenetic modifications affected the proximal tubule cells and fenestrated endothelial cells, leading to tubule injury and hypoxia through transcriptional regulation. Strikingly, loss of DNA hydroxymethylation and DNA hypermethylation in vitamin C-deficient kidneys preceded the histologic sign of tubule necrosis, indicating the causality of vitamin C-induced epigenetic modification in ATN. Consistently, prophylactic supplementation of an oxidation-resistant vitamin C derivative, ascorbyl phosphate magnesium, promoted DNA demethylation and prevented the progression of cisplatin-induced ATN.. Vitamin C played a critical role in renal homeostasis and pathogenesis in a mouse model, suggesting vitamin supplementation may be an approach to lower the risk of kidney injury.

Topics: Animals; Ascorbic Acid; Ascorbic Acid Deficiency; Disease Models, Animal; Endothelial Cells; Epigenesis, Genetic; Female; Humans; Kidney Tubular Necrosis, Acute; Male; Mice; Necrosis; RNA

Hyperoxaluria can result in oxalate nephropathy with intratubular calcium oxalate crystallization and acute tubular injury. Primary inherited enzymatic deficiency or secondary causes such as excessive dietary intake, enteric increased absorption, or high doses of vitamin C, which is metabolized to oxalate, may underlie hyperoxaluria and oxalate nephropathy. We report a case of acute kidney injury due to oxalate nephropathy in a patient using chelating therapy with oral ethylenediamine tetra acetic acid (EDTA), intravenous supplementation with vitamin C, and chronic diarrhea and discuss the potential kidney damage these factors can cause in particular settings. To our knowledge, this is the first report suggesting an association between oral EDTA and oxalate nephropathy.

Topics: Acute Kidney Injury; Aged; Ascorbic Acid; Calcium Chelating Agents; Calcium Oxalate; Diarrhea; Edetic Acid; Humans; Hyperoxaluria; Kidney Tubular Necrosis, Acute; Male; Renal Dialysis; Vitamins

During times of war and natural disasters, rhabdomyolysis-induced myoglobinuric acute renal failure (ARF) can assume epidemic proportions. Free radicals play an important role in the pathogenesis of myoglobinuric ARF. Vitamin C is a major antioxidant, scavenging free radicals. We have not found any studies on the effect of vitamin C on myoglobinuric ARF. Thus, we aimed to investigate the effects of vitamin C on the myoglobinuric ARF formed by glycerol in rats. Three groups of rats were employed in this study. Group 1 served as control, group 2 was given 50% glycerol (10 mL/kg, i.m.), and group 3 was given glycerol plus vitamin C (20 mg/kg, i.p. for four days). Ninety-six hours after glycerol injections, blood samples and kidney tissues were taken from the anesthetized rats. Urea and creatinine levels in plasma; N-acetyl-beta-D-glucosaminidase activity in urine; malondialdehyde levels, superoxide dismutase and catalase enzyme activity in kidney tissue were determined. Histopathological changes and iron accumulation in the kidney tissue were evaluated. In this study, glycerol administration led to marked renal oxidative stress and severe renal functional and morphological deterioration. The treatment of animals with vitamin C partially corrected the renal dysfunction and morphological impairment. In this respect, vitamin C appears to be a promising candidate for the prevention of rhabdomyolysis-induced ARF. Higher dosages of vitamin C than in 20 mg/kg may be beneficial for better functional and morphological recovery in this model ARF.

Topics: Acute Kidney Injury; Animals; Ascorbic Acid; Biopsy, Needle; Disease Models, Animal; Glycerol; Immunohistochemistry; Kidney Function Tests; Kidney Tubular Necrosis, Acute; Male; Malondialdehyde; Myoglobinuria; Probability; Random Allocation; Rats; Rats, Sprague-Dawley; Reference Values; Rhabdomyolysis; Sensitivity and Specificity; Severity of Illness Index; Statistics, Nonparametric

Oxalosis, or calcium oxalate deposition in the tissues, may develop in patients with inherited disorders of oxalate metabolism or can occur secondary to other diseases. In this study, a case of renal oxalosis probably secondary to excessive parenteral vitamin C administration in a patient with acute post-traumatic oliguric renal failure is reported. Oxalate deposits may have contributed to further worsening and delayed recovery of renal function. The elimination of the source of excess vitamin C and its presumed effect on oxalate production, together with enhanced removal of oxalate during aggressive dialysis, resulted in prompt recovery of renal function. Secondary oxalosis represents a possible cause of delayed recovery of renal function in patients with acute renal failure who are receiving vitamin C supplementation if excess dosage of that supplementation is given. Vitamin C supplementation, if utilized, should be carefully monitored in patients receiving artificial renal replacement therapy.

Topics: Ascorbic Acid; Biopsy; Calcium Oxalate; Dose-Response Relationship, Drug; Fatal Outcome; Humans; Hyperoxaluria; Infusions, Intravenous; Kidney; Kidney Function Tests; Kidney Tubular Necrosis, Acute; Male; Middle Aged; Renal Dialysis

Four-week-old Wistar male rats were fed a vitamin E (VE)-deficient diet for 8 weeks, followed by intraperitoneal injection of DL-buthionine- [S, R] -sulfoximine (BSO), an inhibitor of gamma-glutamylcysteine synthetase, at the dose of 1 mmol/kg body weight. As we reported previously, GSH depletion by administration of BSO induced acute tubular necrosis in the kidney of VE-deficient rats and was accompanied by decrease of renal TBA value and marked increase of renal lipofuscin content. In this study, we examined the effect of administration of AsA or Trolox C on these kidney injuries. AsA or Trolox C treatment increased renal GSH content and inhibited the increase of renal lipofuscin production. The increase of BUN and creatinine levels and LDH activity in the sera of rats administered BSO were inhibited by AsA or Trolox C treatment. AsA treatment completely protected the necrosis of epithelia of proximal renal tubules. These results suggest that GSH has an important role in preventing lipofuscin production through the reaction of lipid peroxides with amino acids. AsA spares GSH indicating that these compounds have similar antioxidant actions and that AsA can serve as an essential antioxidant in the presence of severe GSH deficiency.

Topics: Animals; Ascorbic Acid; Buthionine Sulfoximine; Chromans; Glutathione; Kidney Tubular Necrosis, Acute; Male; Methionine Sulfoximine; Rats; Rats, Wistar; Vitamin E; Vitamin E Deficiency

Administration of either 2,5-dichloro-3-(glutathion-S-yl)-1, 4-benzoquinone (DC-[GSyl]BQ) or 2,5,6-trichloro-3-(glutathion-S-yl)-1,4-benzoquinone (TC-[GSyl]BQ) to male Sprague-Dawley rats caused dose-dependent (50-200 mumol/kg; iv) renal proximal tubular necrosis, as evidenced by elevations in blood urea nitrogen (BUN), and in the urinary excretion of lactate dehydrogenase (LDH), gamma-glutamyl transpeptidase (gamma-GT) and glucose. Renal proximal tubular necrosis was also confirmed by histological examination of kidney slices prepared from DC-(GSyl)BQ- and TC-(GSyl)BQ-treated animals. Administration of the corresponding hydroquinone conjugates (DC-[GSyl]HQ and TC-[GSyl]HQ), prepared by reducing the quinones with a threefold molar excess of ascorbic acid, resulted in a substantial increase in nephrotoxicity. Moreover, in contrast to other glutathione (GSH)-conjugated hydroquinones, the nephrotoxicity of both DC-(GSyl)HQ and TC-(GSyl)HQ was potentiated when rats were pretreated with AT-125, an irreversible inhibitor of gamma-GT. Neither the quinone-GSH nor the hydroquinone-GSH conjugates caused any effect on liver histology or serum glutamate-pyruvate transaminase levels. The results suggest that coadministration of ascorbic acid with DC-(GSyl)BQ or TC-(GSyl)BQ decreases their interactions with extrarenal nucleophiles, including plasma proteins, and thus increases the concentration of the conjugates delivered to the kidney, and hence toxicity. Furthermore the ability of AT-125 to potentiate the nephrotoxicity of DC-(GSyl)HQ and TC-(GSyl)HQ suggests that metabolism of these conjugates by gamma-GT constitutes a detoxication reaction.

Topics: Animals; Ascorbic Acid; Chloranil; Chromatography, High Pressure Liquid; Dose-Response Relationship, Drug; Drug Synergism; Electrochemistry; gamma-Glutamyltransferase; Glutathione; Isoxazoles; Kidney Cortex; Kidney Diseases; Kidney Tubular Necrosis, Acute; Male; Oxidation-Reduction; Rats; Rats, Inbred Strains