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L-carnitine in dialysis patients
1Scribner Kidney Center and the Department of Medicine, University of Washington, Seattle, Washington 98133, USA.
Seminars in Dialysis
|June 26, 2001
Summary
L-carnitine supplementation may improve symptoms in hemodialysis patients, particularly anemia and muscle issues. However, routine use is not recommended; a trial is suggested for symptomatic individuals.
Area of Science:
- Nephrology
- Biochemistry
- Clinical Nutrition
Background:
- Hemodialysis (HD) patients frequently exhibit low serum free L-carnitine and reduced muscle L-carnitine stores.
- L-carnitine is vital for fatty acid and energy metabolism, suggesting its deficiency may contribute to complications in HD patients.
Purpose of the Study:
- To evaluate the potential benefits of L-carnitine supplementation in addressing clinical problems associated with abnormal carnitine metabolism in hemodialysis patients.
Main Methods:
- Review of studies investigating L-carnitine supplementation in hemodialysis patients.
- Analysis of reported improvements in cardiac function, exercise capacity, intradialytic symptoms, and anemia.
Main Results:
- L-carnitine supplementation demonstrated improvements in cardiac complications, exercise capacity, intradialytic hypotension, and muscle symptoms.
- Significant positive effects were observed in treating erythropoietin-resistant anemia.
Conclusions:
- While routine L-carnitine administration is not advised for all HD patients, a therapeutic trial can benefit symptomatic individuals with specific conditions.
- Consideration for L-carnitine trial in patients with intradialytic muscle cramps, hypotension, asthenia, cardiomyopathy, or EPO-resistant anemia.