Evidence map›Paper›PMID 41515248›Full record

ReviewNutrients2025

Vitamin C and Benzoic Acid Intake in Patients with Kidney Disease: Is There Risk of Benzene Exposure?

Manuela Yepes-Calderón, Caecilia S E Doorenbos, Eva Corpeleijn, Casper F M Franssen, Michel J Vos, Daan J Touw, Christophe Mariat, Annelies E de Weerd, Stephan J L Bakker

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Nutrients, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Manuela Yepes-CalderónDivision of Nephrology, Department of Internal Medicine, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands.ORCID 0000-0002-4693-5974
Caecilia S E DoorenbosDivision of Nephrology, Department of Internal Medicine, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands.
Eva CorpeleijnDepartment of Epidemiology, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands.ORCID 0000-0002-2974-3305
Casper F M FranssenDivision of Nephrology, Department of Internal Medicine, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands.ORCID 0000-0003-1004-9994
Michel J VosDepartment of Laboratory Medicine, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands.ORCID 0000-0001-9379-2219
Daan J TouwDepartment of Pharmacology, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands.ORCID 0000-0002-1429-4789
Christophe MariatDivision of Nephrology, Department of Internal Medicine, Hôpital Nord CHU de Sainte-Etienne, 42270 Saint-Etienne, France.
Annelies E de WeerdDivision of Nephrology, Department of Internal Medicine, Erasmus Medical Centre, 3015 GD Rotterdam, The Netherlands.
Stephan J L BakkerDivision of Nephrology, Department of Internal Medicine, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands.ORCID 0000-0003-3356-6791

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Vitamin C is a small water-soluble molecule primarily cleared by the kidneys. Therefore, its plasma concentration would be expected to increase as kidney function declines. However, studies in patients with chronic kidney disease (CKD) and kidney transplant recipients have shown the opposite: a positive correlation between kidney function and plasma vitamin C levels. In this review, we discuss potential explanations for this counterintuitive finding and suggest alternative mechanisms influencing vitamin C bioavailability in this population. We also explore the hypothesis that this phenomenon may be linked to benzoic acid (benzoate) exposure. Benzoic acid is a widely used food preservative that, like vitamin C, is water-soluble and renally excreted. In individuals with impaired kidney function, reduced clearance may lead to elevated circulating benzoic acid levels, which could increase the likelihood of an in vivo chemical reaction between benzoic acid and vitamin C, resulting in the formation of benzene, which is a known toxic and carcinogenic compound. We summarize experimental evidence demonstrating the vitamin C-benzoic acid reaction in vitro, along with preliminary animal studies suggesting it may also occur in vivo. We also discuss the potential clinical consequences of benzene exposure in the context of patients with kidney function impairment. Given the widespread use of benzoic acid as a food preservative and the ongoing discussion around vitamin C supplementation in patients with kidney disease, this review invites further investigation to evaluate whether this reaction represents a health hazard for this population.

Indexed as

Ascorbic AcidBenzeneBenzoic AcidFood PreservativesRenal Insufficiency, ChronicAnimalsHumansAscorbic AcidBenzeneBenzoic AcidFood Preservativesbenzenebenzoatebenzoic acidchronic kidney diseasevitamin C

Identifiers

PMID41515248
PMCPMC12788075

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.