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The Protective Effect of Vitamin C Targeting Oxidative Stress on Renal Function in Patients with Septic Acute Kidney Injury: A Prospective, Randomized Controlled, Pilot Study.

  • 2026-02-04
  • International journal for vitamin and nutrition research. Internationale Zeitschrift fur Vitamin- und Ernahrungsforschung. Journal international de vitaminologie et de nutrition 96(1)
    • Yu Chen
    • Min Lu
    • Xuee Shi
    • Fang Feng
    • Jinquan Zhou

Study Design

Type
Randomized Controlled Trial (RCT)
Sample size
n = 40
Population
40 patients with sepsis
Methods
prospective, randomized and controlled pilot trial; experimental group given vitamin C (1.5 g every 6 h by intravenous infusion) for 3 consecutive days, control group given placebo; all received comprehensive initial treatment for sepsis
Duration
3 consecutive days

Objective

To explore whether vitamin C supplementation in sepsis patients can reduce the occurrence of acute kidney injury.

Methods

A prospective, randomized and controlled pilot trial was conducted. All individuals participating in the study received comprehensive initial treatment for sepsis. This involved monitoring lactate levels, ensuring appropriate fluid resuscitation, administering empiric broad-spectrum antibiotics, and using vasoactive medications, with a preference for norepinephrine. If the norepinephrine dosage exceeded 20 μg/min, vasopressin was introduced at a rate of 0.03 U/min to sustain a mean arterial pressure of at least 65 mmHg. The experimental group was given vitamin C (1.5 g every 6 h by intravenous infusion) for 3 consecutive days, while the control group was given placebo.

Results

A total of 40 patients with sepsis were included in the study following application of the inclusion and exclusion criteria. Patients were randomized into control (n = 20) and experimental (n = 20) groups. No significant differences in baseline characteristics were found between the two groups (all p > 0.05). Among the 40 sepsis patients, 5 (25%) in the experimental group and 14 (70%) in the control group developed acute kidney injury, all of whom required support with continuous renal replacement therapy (RRT). The main site of infection was pulmonary, accounting for 70% of cases in the experimental group and 75% in the control group. The most common pathogenic bacteria were gram-negative bacilli (26/40, 65%). The experimental group had a significantly shorter length of stay in intensive care unit (ICU) compared to the control group (11.8 ± 2.7 days vs. 13.9 ± 2.1 days, p = 0.008), less frequent use of vasoactive drugs (35% vs. 75%, p = 0.011), and less frequent need for RRT within 72 h of admission (25% vs. 70%, p = 0.004). However, the mortality rate in ICU was not significantly different (10% vs. 15%, p = 0.633).

Conclusion

The use of vitamin C in patients with sepsis is associated with a reduced incidence of acute kidney injury, although a larger sample size is required to confirm this finding.

Clinical trial registration

This trial was registered at Chinese Clinical Trial Registry (ChiCTR2400093794, https://www.chictr.org.cn/hvshowproject.html?id=265499&v=1.0).

Research Insights

  • Vitamin C→Reduced Acute Kidney Injury

    Among the 40 sepsis patients, 5 (25%) in the experimental group and 14 (70%) in the control group developed acute kidney injury

    Effect
    Beneficial
    Effect size
    Large
    Dose
    1.5 g every 6 h by intravenous infusion for 3 consecutive days
  • Vitamin C→Reduced Intensive Care Unit Stay

    The experimental group had a significantly shorter length of stay in intensive care unit (ICU) compared to the control group (11.8 ± 2.7 days vs. 13.9 ± 2.1 days, p = 0.008)

    Effect
    Beneficial
    Effect size
    Moderate
    Dose
    1.5 g every 6 h by intravenous infusion for 3 consecutive days
  • Vitamin C→Reduced Mortality Rate

    the mortality rate in ICU was not significantly different (10% vs. 15%, p = 0.633)

    Effect
    Neutral
    Effect size
    Small
    Dose
    1.5 g every 6 h by intravenous infusion for 3 consecutive days
  • Vitamin C→Reduced Need for Continuous Renal Replacement Therapy

    less frequent need for RRT within 72 h of admission (25% vs. 70%, p = 0.004)

    Effect
    Beneficial
    Effect size
    Large
    Dose
    1.5 g every 6 h by intravenous infusion for 3 consecutive days
  • Vitamin C→Reduced Use of Vasoactive Drugs

    less frequent use of vasoactive drugs (35% vs. 75%, p = 0.011)

    Effect
    Beneficial
    Effect size
    Large
    Dose
    1.5 g every 6 h by intravenous infusion for 3 consecutive days
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