Is intravenous ascorbic acid an effective and safe option for increasing hemoglobin levels in patients with a hyporesponse to epoetin alfa?

Despite the use of epoetin alfa, over one-third of patients with end stage renal disease have persistent anemia. The nephrology literature cites various erythropoietin adjuvants that may have the potential to improve the efficiency of anemia management, and one option is ascorbic acid. This article reviews the published data on the effectiveness of intravenous ascorbic acid in increasing the hemoglobin levels of patients with hyporesponse to epoetin alfa, as well as adverse effects of the administration of intravenous ascorbic acid specifically in relation to hyperoxalemia.