Comparison of Oral Iron Alone with Oral Iron Plus Oral Ascorbic Acid in the Treatment of Anemia in Chronic Kidney Disease Patients

Abstract

Objectives: To compare mean hemoglobin concentration in chronic kidney disease patients with anemia treated with Iron alone and Iron plus oral Ascorbic Acid. Methodology: This study was conducted at the Department of Nephrology, Allied Hospital, Faisalabad during the period from from 8 January 2025 to 8 May 2025. A total of 60 patients were randomly assigned to two groups: Group A (oral iron only, n=30) and Group B (oral iron + oral ascorbic acid, n=30). Hemoglobin concentration was recorded at baseline and after 3 months. Subgroup analysis was performed by age, gender, BMI, and CKD etiology. Results: Baseline hemoglobin levels were comparable between both groups (p=0.427). After 3 months, Group B demonstrated a significantly higher increase in hemoglobin (10.96 ± 1.11 g/dL) compared to Group A (9.57 ± 1.06 g/dL), (p=<0.001). Stratified analysis showed greater hemoglobin improvement in the combination therapy group across all subgroups, especially among younger patients, females, and those with glomerulonephritis. Conclusion: The combination of oral iron with ascorbic acid is more effective than iron alone in improving hemoglobin levels in CKD-associated anemia. This simple, cost-effective strategy may be particularly valuable in low-resource settings.