Decreased plasma level of vitamin C in chronic kidney disease: comparison between diabetic and non-diabetic patients

Nephrol Dial Transplant. 2011 Apr;26(4):1252-7. doi: 10.1093/ndt/gfq547. Epub 2010 Sep 3.


Background: A decreased plasma level of vitamin C has been reported to be associated with an increased risk of cardiovascular morbidity and mortality. Here, we sought to determine the vitamin C status of patients with chronic kidney disease and the pathophysiological role of vitamin C in these patients.

Methods: We studied 58 patients and evaluated the relationship between renal function and plasma vitamin C concentration, as well as the effect of diabetes on this relationship. Endothelium-dependent flow-mediated dilation of brachial artery was measured to assess the endothelial function. Serum malondialdehyde low-density lipoprotein was measured as a marker for oxidative stress.

Results: Plasma vitamin C concentration had a positive linear relationship with eGFR in both diabetic and non-diabetic patients (P = 0.006 and P = 0.004, respectively). When vitamin C concentration and eGFR relationships were compared in the two groups, vitamin C concentration was significantly lower in diabetic patients at every eGFR (P = 0.006). Flow-mediated vasodilatation of the brachial artery was positively correlated with vitamin C concentration in non-diabetic patients (P = 0.047) but not in diabetic patients. There was a negative correlation between serum malondialdehyde low-density lipoprotein and vitamin C concentration in non-diabetic patients (P = 0.044) but not in diabetic patients.

Conclusions: Renal dysfunction was associated with a decrease in plasma vitamin C level. Moreover, decreased vitamin C may cause endothelial dysfunction via an increase in oxidative stress in non-diabetic chronic kidney disease patients.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antioxidants / metabolism*
  • Ascorbic Acid / blood*
  • Ascorbic Acid Deficiency / complications*
  • Diabetes Mellitus, Type 2 / physiopathology*
  • Female
  • Humans
  • Kidney Function Tests
  • Male
  • Middle Aged
  • Prognosis
  • Renal Insufficiency, Chronic / blood
  • Renal Insufficiency, Chronic / etiology*


  • Antioxidants
  • Ascorbic Acid