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High dose intravenous vitamin C treatment in Sepsis: associations with acute kidney injury and mortality

BACKGROUND: The effects of vitamin C on clinical outcomes in critically ill patients remain controversial due to inconclusive studies. This retrospective observational cohort study evaluated the effects of vitamin C therapy on acute kidney injury (AKI) and mortality among septic patients. METHODS: E...

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Autores principales: McCune, Thomas R., Toepp, Angela J., Sheehan, Brynn E., Sherani, Muhammad Shaheer K., Petr, Stephen T., Dodani, Sunita
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8606062/
https://www.ncbi.nlm.nih.gov/pubmed/34800992
http://dx.doi.org/10.1186/s12882-021-02599-1
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author McCune, Thomas R.
Toepp, Angela J.
Sheehan, Brynn E.
Sherani, Muhammad Shaheer K.
Petr, Stephen T.
Dodani, Sunita
author_facet McCune, Thomas R.
Toepp, Angela J.
Sheehan, Brynn E.
Sherani, Muhammad Shaheer K.
Petr, Stephen T.
Dodani, Sunita
author_sort McCune, Thomas R.
collection PubMed
description BACKGROUND: The effects of vitamin C on clinical outcomes in critically ill patients remain controversial due to inconclusive studies. This retrospective observational cohort study evaluated the effects of vitamin C therapy on acute kidney injury (AKI) and mortality among septic patients. METHODS: Electronic medical records of 1390 patients from an academic hospital who were categorized as Treatment (received at least one dose of 1.5 g IV vitamin C, n = 212) or Comparison (received no, or less than 1.5 g IV vitamin C, n = 1178) were reviewed. Propensity score matching was conducted to balance a number of covariates between groups. Multivariate logistic regressions were conducted predicting AKI and in-hospital mortality among the full sample and a sub-sample of patients seen in the ICU. RESULTS: Data revealed that vitamin C therapy was associated with increases in AKI (OR = 2.07 95% CI [1.46–2.93]) and in-hospital mortality (OR = 1.67 95% CI [1.003–2.78]) after adjusting for demographic and clinical covariates. When stratified to examine ICU patients, vitamin C therapy remained a significant risk factor of AKI (OR = 1.61 95% CI [1.09–2.39]) and provided no protective benefit against mortality (OR = 0.79 95% CI [0.48–1.31]). CONCLUSION: Ongoing use of high dose vitamin C in sepsis should be appraised due to observed associations with AKI and death.
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spelling pubmed-86060622021-11-22 High dose intravenous vitamin C treatment in Sepsis: associations with acute kidney injury and mortality McCune, Thomas R. Toepp, Angela J. Sheehan, Brynn E. Sherani, Muhammad Shaheer K. Petr, Stephen T. Dodani, Sunita BMC Nephrol Research Article BACKGROUND: The effects of vitamin C on clinical outcomes in critically ill patients remain controversial due to inconclusive studies. This retrospective observational cohort study evaluated the effects of vitamin C therapy on acute kidney injury (AKI) and mortality among septic patients. METHODS: Electronic medical records of 1390 patients from an academic hospital who were categorized as Treatment (received at least one dose of 1.5 g IV vitamin C, n = 212) or Comparison (received no, or less than 1.5 g IV vitamin C, n = 1178) were reviewed. Propensity score matching was conducted to balance a number of covariates between groups. Multivariate logistic regressions were conducted predicting AKI and in-hospital mortality among the full sample and a sub-sample of patients seen in the ICU. RESULTS: Data revealed that vitamin C therapy was associated with increases in AKI (OR = 2.07 95% CI [1.46–2.93]) and in-hospital mortality (OR = 1.67 95% CI [1.003–2.78]) after adjusting for demographic and clinical covariates. When stratified to examine ICU patients, vitamin C therapy remained a significant risk factor of AKI (OR = 1.61 95% CI [1.09–2.39]) and provided no protective benefit against mortality (OR = 0.79 95% CI [0.48–1.31]). CONCLUSION: Ongoing use of high dose vitamin C in sepsis should be appraised due to observed associations with AKI and death. BioMed Central 2021-11-20 /pmc/articles/PMC8606062/ /pubmed/34800992 http://dx.doi.org/10.1186/s12882-021-02599-1 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
McCune, Thomas R.
Toepp, Angela J.
Sheehan, Brynn E.
Sherani, Muhammad Shaheer K.
Petr, Stephen T.
Dodani, Sunita
High dose intravenous vitamin C treatment in Sepsis: associations with acute kidney injury and mortality
title High dose intravenous vitamin C treatment in Sepsis: associations with acute kidney injury and mortality
title_full High dose intravenous vitamin C treatment in Sepsis: associations with acute kidney injury and mortality
title_fullStr High dose intravenous vitamin C treatment in Sepsis: associations with acute kidney injury and mortality
title_full_unstemmed High dose intravenous vitamin C treatment in Sepsis: associations with acute kidney injury and mortality
title_short High dose intravenous vitamin C treatment in Sepsis: associations with acute kidney injury and mortality
title_sort high dose intravenous vitamin c treatment in sepsis: associations with acute kidney injury and mortality
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8606062/
https://www.ncbi.nlm.nih.gov/pubmed/34800992
http://dx.doi.org/10.1186/s12882-021-02599-1
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