Oxalate Nephropathy After Continuous Infusion of High-Dose Vitamin C as an Adjunct to Burn Resuscitation

Michelle Buehner, Jeremy Pamplin, Lynette Studer, Rhome L Hughes, Booker T King, John C Graybill, Kevin K Chung, Michelle Buehner, Jeremy Pamplin, Lynette Studer, Rhome L Hughes, Booker T King, John C Graybill, Kevin K Chung

Abstract

Fluid resuscitation is the foundation of management in burn patients and is the topic of considerable research. One adjunct in burn resuscitation is continuous, high-dose vitamin C (ascorbic acid) infusion, which may reduce fluid requirements and thus decrease the risk for over resuscitation. Research in preclinical studies and clinical trials has shown continuous infusions of high-dose vitamin C to be beneficial with decrease in resuscitative volumes and limited adverse effects. However, high-dose and low-dose vitamin C supplementation has been shown to cause secondary calcium oxalate nephropathy, worsen acute kidney injury, and delay renal recovery in non-burn patients. To the best of our knowledge, the authors present the first case series in burn patients in whom calcium oxalate nephropathy has been identified after high-dose vitamin C therapy.

Conflict of interest statement

The views expressed herein are those of the authors and do not reflect the official policy or position of Brooke Army Medical Center, the U.S. Army Medical Department, the U.S. Army Office of the Surgeon General, the Department of the Army, the Department of the Air Force, and Department of Defense or the U.S. Government. The undersigned authors transfer all copyright ownership of this article to the American Burn Association in the event the work is published. The undersigned authors warrant that the article is original, does not infringe on any copyright or proprietary right of any third party, is not under consideration by another journal, and has not been previously published. The final manuscript has been read, and each author’s contribution has been approved by the appropriate author. No conflicts of interest are noted.

Figures

Figure 1.
Figure 1.
High power (×40) view of birefringent calcium oxalate crystals with “fan-shaped” morphology.

References

    1. Kremer T, Harenberg P, Hernekamp F, et al. High-dose vitamin C treatment reduces capillary leakage after burn plasma transfer in rats. J Burn Care Res. 2010;31:470–9.
    1. Lund T, Onarheim H, Reed RK. Pathogenesis of edema formation in burn injuries. World J Surg. 1992;16:2–9.
    1. Matsuda T, Tanaka H, Williams S, Hanumadass M, Abcarian H, Reyes H. Reduced fluid volume requirement for resuscitation of third-degree burns with high-dose vitamin C. J Burn Care Rehabil. 1991;12:525–32.
    1. Tanaka H, Lund T, Wiig H, et al. High dose vitamin C counteracts the negative interstitial fluid hydrostatic pressure and early edema generation in thermally injured rats. Burns. 1999;25:569–74.
    1. Horton JW. Free radicals and lipid peroxidation mediated injury in burn trauma: the role of antioxidant therapy. Toxicology. 2003;189:75–88.
    1. Tanaka H, Matsuda T, Miyagantani Y, Yukioka T, Matsuda H, Shimazaki S. Reduction of resuscitation fluid volumes in severely burned patients using ascorbic acid administration: a randomized, prospective study. Arch Surg. 2000;135:326–31.
    1. Kramer GC, Lund T, Herndon DN. Pathophysiology of burn shock and burn edema. In: D. Herndon., editor. Total burn care. Philadelphia: Saunders; 2002. pp. 78–87.
    1. Dubick MA, Williams C, Elgjo GI, Kramer GC. High-dose vitamin C infusion reduces fluid requirements in the resuscitation of burn-injured sheep. Shock. 2005;24:139–44.
    1. Chung KK, Wolf SE, Cancio LC, et al. Resuscitation of severely burned military casualties: fluid begets more fluid. J Trauma. 2009;67:231–7. discussion 237.
    1. Alvarado R, Chung KK, Cancio LC, Wolf SE. Burn resuscitation. Burns. 2009;35:4–14.
    1. Warden GD. In: Fluid resuscitation and early management. in Total Burn Care. D. Herndon., editor. Philadelphia: Saunders; 2002. pp. 88–97.
    1. Pruitt BA., Jr Protection from excessive resuscitation: “pushing the pendulum back”. J Trauma. 2000;49:567–8.
    1. Kahn SA, Beers RJ, Lentz CW. Resuscitation after severe burn injury using high-dose ascorbic acid: a retrospective review. J Burn Care Res. 2011;32:110–7.
    1. Nishikimi M. Oxidation of ascorbic acid with superoxide anion generated by the xanthine-xanthine oxidase system. Biochem Biophys Res Commun. 1975;63:463–8.
    1. Matsuda T, Tanaka H, Reyes HM, et al. Antioxidant therapy using high dose vitamin C: reduction of postburn resuscitation fluid volume requirements. World J Surg. 1995;19:287–91.
    1. Sakurai M, Tanaka H, Matsuda T, Goya T, Shimazaki S, Matsuda H. Reduced resuscitation fluid volume for second-degree experimental burns with delayed initiation of vitamin C therapy (beginning 6 h after injury). J Surg Res. 1997;73:24–7.
    1. Salinas J, Chung KK, Mann EA, et al. Computerized decision support system improves fluid resuscitation following severe burns: an original study. Crit Care Med. 2011;39:2031–8.
    1. Till GO, Guilds LS, Mahrougui M, Friedl HP, Trentz O, Ward PA. Role of xanthine oxidase in thermal injury of skin. Am J Pathol. 1989;135:195–202.
    1. Ward PA, Till GO. Pathophysiologic events related to thermal injury of skin. J Trauma. 1990;30(12 Suppl):S75–9.
    1. Edgar DW, Fish JS, Gomez M, Wood FM. Local and systemic treatments for acute edema after burn injury: a systematic review of the literature. J Burn Care Res. 2011;32:334–47.
    1. Kahn SA, Lentz CW. Fictitious hyperglycemia: point-of-care glucose measurement is inaccurate during high-dose vitamin c infusion for burn shock resuscitation. J Burn Care Res. 2015;36:e67–71.
    1. Bielski BH, Richter HW, Chan PC. Some properties of the ascorbate free radical. Ann N Y Acad Sci. 1975;258:231–7.
    1. Niki E. Interaction of ascorbate and alpha-tocopherol. Ann N Y Acad Sci. 1987;498:186–99.
    1. Johnston CS, Retrum KR, Srilakshmi JC. Antihistamine effects and complications of supplemental vitamin C. J Am Diet Assoc. 1992;92:988–9.
    1. Murad S, Grove D, Lindberg KA, Reynolds G, Sivarajah A, Pinnell SR. Regulation of collagen synthesis by ascorbic acid. Proc Natl Acad Sci U S A. 1981;78:2879–82.
    1. Matsuda T, Tanaka H, Yuasa H, et al. The effects of high-dose vitamin C therapy on postburn lipid peroxidation. J Burn Care Rehabil. 1993;14:624–9.
    1. Tanaka H, Matsuda H, Shimazaki S, Hanumadass M, Matsuda T. Reduced resuscitation fluid volume for second-degree burns with delayed initiation of ascorbic acid therapy. Arch Surg. 1997;132:158–61.
    1. Dylewski DF, Froman DM. Vitamin C supplementation in the patient with burns and renal failure. J Burn Care Rehabil. 1992;13:378–80.
    1. Gottschlich MM, Warden GD. Vitamin supplementation in the patient with burns. J Burn Care Rehabil. 1990;11:275–9.
    1. Food and Nutrition Board. Dietary reference intakes: applications in dietary Assessment. Washington, DC: National Academy Press; 2000. pp. 284–9.
    1. Department of Surgical Education, O.R.M.C. Ascorbic Acid (Vitamin C) Infusion in the Resuscitation of Burn Patients. 2006.
    1. Lamarche J, Nair R, Peguero A, Courville C. Vitamin C-induced oxalate nephropathy. Int J Nephrol. 2011;2011:146927.
    1. Wong K, Thomson C, Bailey RR, McDiarmid S, Gardner J. Acute oxalate nephropathy after a massive intravenous dose of vitamin C. Aust N Z J Med. 1994;24:410–1.
    1. Alkhunaizi AM, Chan L. Secondary oxalosis: a cause of delayed recovery of renal function in the setting of acute renal failure. J Am Soc Nephrol. 1996;7:2320–6.
    1. Lawton JM, Conway LT, Crosson JT, Smith CL, Abraham PA. Acute oxalate nephropathy after massive ascorbic acid administration. Arch Intern Med. 1985;145:950–1.
    1. Gurm H, Sheta MA, Nivera N, Tunkel A. Vitamin C-induced oxalate nephropathy: a case report. J Community Hosp Intern Med Perspect. 2012;2
    1. Mashour S, Turner JF, Jr, Merrell R. Acute renal failure, oxalosis, and vitamin C supplementation: a case report and review of the literature. Chest. 2000;118:561–3.
    1. Dubick MA. A review of the use of high dose vitamin C for the treatment of burns. Recent Res Dev Nutr. 2000;3:141–56.
    1. Chung KK, Salinas J, Renz EM, et al. Simple derivation of the initial fluid rate for the resuscitation of severely burned adult combat casualties: in silico validation of the rule of 10. J Trauma. 2010;69(Suppl 1):S49–54.

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