Abstract: FR-PO0214
Ascorbic Acid as Adjunct Therapy for Anemia in Patients Undergoing Hemodialysis: Systematic Review and Meta-Analysis
Session Information
- Anemia and Iron Metabolism
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Anemia and Iron Metabolism
- 200 Anemia and Iron Metabolism
Authors
- Calderon Martinez, Ernesto, The University of Texas Health Science Center at Houston, Houston, Texas, United States
- Sánchez Cruz, Camila, Universidad Nacional Autonoma de Mexico, Mexico City, CDMX, Mexico
- De la Rosa Valdez, España, Universidad Autonoma de Nuevo Leon, San Nicolás de los Garza, N.L., Mexico
- Magallanes Bajana, Angelo, Universidad de Guayaquil, Guayaquil, Guayas, Ecuador
- Beltran Covarrubias, Salma Alejandra, Universidad de Guadalajara, Guadalajara, Jal., Mexico
- Cruz Castillo, Yeison, Universidad Autonoma de Santo Domingo, Santo Domingo, Dominican Republic
- Villa, Montserrat, Centro de Estudios Universitarios Xochicalco, Xochicalco, Mor., Mexico
- Chen, Alejandro, Centro de Estudios Universitarios Xochicalco, Xochicalco, Mor., Mexico
- Sámano, Michelle, Universidad Autonoma de Sinaloa, Culiacán, Sin., Mexico
- Abbagoni, Vaidarshi, St Vincent Medical Center, Bridgeport, Connecticut, United States
Background
Anemia is prevalent in chronic kidney disease, particularly among patients undergoing hemodialysis, contributing to fatigue and reduced quality of life. While standard treatment includes iron and erythropoietin, adjunctive therapies are under investigation. Ascorbic acid may improve iron metabolism by reducing ferric to ferrous iron. This systematic review and meta-analysis evaluated its effect on hematologic and iron parameters.
Methods
Following PRISMA guidelines, a comprehensive search across six databases through May 2025 included randomized and crossover trials assessing ascorbic acid in anemic adults on hemodialysis. Primary outcomes were hemoglobin (Hb), ferritin, iron, transferrin saturation (TSAT), and total iron-binding capacity (TIBC). Meta-analyses used random-effects models. The protocol was registered on PROSPERO (CRD420251056337).
Results
Of the 479 screened articles, a total of 15 studies met the inclusion criteria. The meta-analysis showed that ascorbic acid increased Hb levels (MD = 0.41 g/dL; 95% CI: 0.12 to 0.70; p < 0.01) and TSAT (MD = 7.26; 95% CI: 2.81 to 11.70; p < 0.01). TIBC significantly decreased (MD = -22.54; 95% CI: -42.37 to -2.72; p = 0.02), indicating improved iron utilization. Ferritin levels showed a modest but significant reduction (MD = -80.71; 95% CI: -156.99 to -4.42; p = 0.04), while serum iron levels (MD = -1.92; 95% CI: -28.47 to 24.63; p = 0.89) were unchanged.
Conclusion
Ascorbic acid supplementation improves hemoglobin, TSAT, and TIBC in anemic hemodialysis patients and may facilitate more effective iron utilization. These findings highlight its potential as a safe and accessible adjunct in anemia management, although further standardized, high-quality trials are needed to confirm clinical applicability.
Effects of Ascorbic Acid in Hemodialysis Patients
| Outcome | Effect Estimate (95% CI, p-value) | Interpretation |
| Hemoglobin | 0.41 (0.12 to 0.70, p < 0.01) | Significant increase |
| TSAT | 7.26 (2.81 to 11.70, p < 0.01) | Significant increase |
| TIBC | –22.54 (–42.37 to –2.72, p = 0.02) | Significant decrease |
| Ferritin | –80.71 (–156.99 to –4.42, p = 0.04) | Significant decrease |
| Iron | –1.92 (–28.47 to 24.63, p = 0.89) | No significant change |
TSAT: Transferritin saturation; TIBC: Total Iron-Binding Capacity