BACKGROUND Malnutrition and anorexia are common in children with chronic kidney disease (CKD) and gastrostomy tubes (GT) as well as nasogastric tubes (NGT) have been recommended to maximize nutritional support. The optimal requirement of vitamin C in children with CKD remains to be defined but oxalate is a breakdown product of vitamin C. Elevated vitamin C intake and bone oxalate were identified in two formula-fed dialyzed children with negative genetic testing for primary hyperoxaluria. METHODS We evaluated the impact of nutritional support on serum ascorbic acid and plasma oxalate levels in 13 dialyzed infants and young children. RESULTS All patients were fed by GT or NGT since the first months of life; overall patients were receiving between 145 and 847% of the age-specific DRI for vitamin C. Mean serum ascorbic acid and plasma oxalate levels were elevated (244.7 ± 139.7 μM/L and 44.3 ± 23.1 μM/L, respectively), and values did not differ according to the degree of residual kidney function. Ascorbic acid levels did not correlate with oxalate levels (r = 0.44, p = 0.13). CONCLUSIONS Excessive vitamin C intake may contribute to oxalate accumulation in dialyzed children.

中文翻译：

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维生素 C 超载可能导致接受透析的儿童的全身性草酸中毒。

背景营养不良和厌食症在患有慢性肾病 (CKD) 的儿童中很常见，并且已建议使用胃造口管 (GT) 和鼻胃管 (NGT) 以最大限度地提供营养支持。CKD 儿童维生素 C 的最佳需求量仍有待确定，但草酸盐是维生素 C 的分解产物。在两名因原发性高草酸尿症基因检测呈阴性的配方喂养透析儿童中发现维生素 C 摄入量和骨草酸盐升高。方法 我们评估了营养支持对 13 名透析婴幼儿的血清抗坏血酸和血浆草酸盐水平的影响。结果 所有患者从出生后的头几个月开始接受 GT 或 NGT 喂养；总体而言，患者接受了 145% 至 847% 的特定年龄维生素 C DRI。平均血清抗坏血酸和血浆草酸盐水平升高（分别为 244.7 ± 139.7 μM/L 和 44.3 ± 23.1 μM/L），并且值没有根据残余肾功能的程度而不同。抗坏血酸水平与草酸盐水平无关（r = 0.44，p = 0.13）。结论 过量摄入维生素 C 可能导致透析儿童草酸盐的积累。