Clinical Study On The Influence Of Ascorbic Acid On TNF-α And IL-1β Level In Peripheral Blood Of Maintenance Hemodialysis Patients

Background and objective The advent of dialysis provides effective and safe treatment of patients with ESRD.Clinical evidence suggests that the developing microinflammation condition in advanced CRF appears to be the main cause of malnutrition,hemophthisis,and cardiovascular disease.Evidence has accumulated that oxidative stress is present in haemodialysis(HD) patients,which increased the proinflammatory cytokines TNF-αand IL-1βsignificantly after HD.Vitamin C is an effective water-soluble antioxidant in human plasma against lipid peroxidation,Vitamin C deficiency in dialysis patients,and loss of the vitamin during dialysis sessions,The primary aim of the present study was to evaluate the effects of regular vitamin C intake on well-defined inflammatory markers and its mechanism in HD patients.Methods This study included 60 maintenance hemodialysis patients who were followed-up for more than 6 months in our dialysis center.Of these 60 patients,40 had chronic glomerulitis,8 were diabetic nephropathy,and 12 wrere hypertensive nephropathy,with an average age of 58±13,an average dialysis time of 23±9 months.They were randomly divided into therapy group(AA group,32 patients) and control group (non-AA group,28 patients).20 normal controls were investigated whose average age is 51±6 without high blood pressure and diabetes mellitus.The serum levels of hemoglobin,blood albumin,and serum creatinine were determined.The levels of TNF-α,IL-βwere detected by radioimmunoassay,MDAand AA levels were determined by infrared absorption spectrometry.Add 3.0g Vitamin C into 250ml 0.9% saline solution.Construct pathway in side peripheral vein at internal fistula during the hemodialysis process which lasts 4-5 hours.Results 1.Comparison of general variables between AA group and non-AA group:The ages,original disease,situations of hemoglobin,blood albumin,and serum creatinine of AA group haven no statistically significant difference compared with non-AA group(P＞0.05).2.Comparison of TNF-α,IL-1β,MAD,hs-CRP andAA between the three group:the TNF-α,IL-1β,MAD,hs-CRP were increased in maintenance hemodialysis patients,whose AA was decreased.3.changes of correlated variables after single hemodialysis:after single hemodialysis MHD in patients,TNF-α,MAD,hs-CRP were increased except IL-1β,whose AA was decreased.4 Comparison between AA group and non-AA group after 3 months:the level of TNF-α,IL-1β,MAD,hs-CRP were decreased,the level of AA were increased.Conclusion:Intravenous supplement of AA in mainte nance Hemod-ialysis patients appears to be associated with an improvement of microinflammatory status.