Vitamin C improves resistance but not conduit artery endothelial function in patients with chronic renal failure

Kidney Int. 2003 Apr;63(4):1433-42. doi: 10.1046/j.1523-1755.2003.00852.x.


Background: Chronic renal failure is associated with impaired endothelium-dependent vasodilation and accelerated atherogenesis. To examine whether endogenous reactive oxygen species (ROS) modify endothelial function in renal failure, we evaluated the effect of the antioxidant vitamin C on endothelium-dependent responses in both the conduit and resistance vasculature of subjects with severe renal impairment.

Methods: Endothelial function of the forearm resistance vasculature was assessed using plethysmography to measure the dilator response to intra-arterial acetylcholine (Ach) (25 to 100 nmol/min). Endothelial function of radial and brachial arteries was assessed using vascular ultrasound to measure the dilator response to flow during reactive hyperemia [flow-mediated dilatation (FMD)]. Studies were performed before and after administration of vitamin C by intra-arterial infusion (25 mg/min) in 33 predialysis patients or by intravenous infusion (3 g) in 17 hemodialysis patients.

Results: Parenteral administration of vitamin C resulted in a 100-fold increase (intra-arterial studies) and a 4.5-fold increase (intravenous studies) in serum antioxidant activity. Vitamin C administration increased the dilator response to ACh in resistance vessels (P = 0.01), but did not alter the dilator response to flow in conduit vessels of either dialysis (P = 0.3) or predialysis subjects (P = 0.8). In the presence of the nitric oxide (NO) synthase inhibitor NGmonomethyl-L-arginine (L-NMMA), there was no effect of vitamin C on resistance vessel endothelial function. In all cases the dilator response to the endothelium-independent dilators was unaffected by vitamin C.

Conclusion: Acute administration of vitamin C reduces oxidant stress in renal failure and improves NO-mediated resistance vessel dilatation.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antioxidants / administration & dosage*
  • Ascorbic Acid / administration & dosage*
  • Biomarkers
  • Brachial Artery / physiology
  • Endothelium, Vascular / drug effects
  • Endothelium, Vascular / physiology*
  • Female
  • Humans
  • Kidney Failure, Chronic / drug therapy*
  • Kidney Failure, Chronic / physiopathology*
  • Male
  • Middle Aged
  • Nitric Oxide / metabolism
  • Oxidative Stress / drug effects
  • Radial Artery / physiology
  • Renal Dialysis
  • Vascular Resistance / drug effects*
  • Vasodilation / drug effects


  • Antioxidants
  • Biomarkers
  • Nitric Oxide
  • Ascorbic Acid