الفهرس 
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Abstract
S”_RY ANDCONCLUSION Ii
147
SUMMARY AND CONCLUSION
Our study was oarried out on 15 ureJUo patients. 10
males and 5 females. ranged in age between 21 to 57 years
(mean 37+- 12.07’yeara).
All the patients have been treated by regular
hemodialysis for periods ranged between 6 to 52 months
(mean 21.4 ± 14.07 months).
Osmotio fragility test of red blood oells was performed
• ,for every patient as follows:
1. Before and after hemodialysis. before vitamin C
supplementation.
2. Then. before and after hemodialysis at the end of each
week dUring a period of 4 weeks. during which every
patient was supplemented with oral vitamin C in a
dose of 100 mg/day.
At the same time. serum asoorbio aoid was estimated
as follow.:
1. Before vitamin C supplementation;
2. Then. weekly during the period of ascorbic aoid
supplementation.
Our results demonstrated that the osmotic fragility
of red blood cells of our patients before hemodialysis
and before oral vitamin C supplementation was inoreased.
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148
We refer this increase to two main faotors:
1. The most important one is the impaired sodium pump in
the membrane of red blood oells in uremic patients
resulting in inorease in the intracellular sodium
oonoentration, so there is increased osmotio fragility
and premature red blood .oell destruotion.
2. Defeotive hexose monophosphate shunt would impair red
blood oell defence capacity against oxidant stress.
we also found that the osmotic fragility of red blood
oells of our patients showed insignificant change by
dialysis whether before or during the period of oral
vitamin C supplementation.
We refer this insignificant ohange of the osmotic
fragility by dialysis to the stUdies which done before
and reported that the hypermetabolic status of the
uremic red cells is unchanged by dialysis.
As regards, the effect of oral vitamin C supplementation
on the osmotic fragility, our results demonstrated that
there was significant and progressive improvement of the
osmotio fragility of red oells during the period of oral
vitamin C supplementation.
We refer this improvement to the follOWing possible
meohanisms:
1. Asoorbio acid is required for normal erythropoiesis. It
is also required for the conversion of fclic acid into
folinic acid.
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149
2. Asoorbio aoid is known to inorease gastrointestinal
iron absor~tion.
J. Asoorbio aoid is also known to promote the release of
iron from reticulo~ndothe1ial deposits.
4. Asoorbio aoid increase the availability of iron by
inoreased maintenance of iron in the ferrous state.
5. Ascorbio acid has long been known to have antioxidant
properties.
Our oonc1usion iSI the osmotic fragility of red blood
oel1s of uremio patients under maintenance hemodialysis is
increased and this increase is not improved by hemodialysis
but improved by oral vitamin C supplementation in a dose
of 100 mgt .day.
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