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L-carnitine supplementation in hemodialysis patients
Ahmed Hassan Mitwalli1, Jamal S Al-Wakeel, Awatif Alam
1Department of Medicine, Division of Nephrology, King Khalid University Hospital, Saudi Arabia.
Abstract:
L-Carnitine supplementation has shown beneficial effects in patients on hemodialysis. We studied 36 ESRD adult patients with a mean age of 47.5 +/- 15 years to evaluate the effect of L-Carnitine supplementation on hemoglobin, lipid levels and physical performance in patients on hemodialysis. The study group consisted of 18 randomly selected patients who received L-Carnitine 15 mg/kg and the control group consisted of 18 randomly selected patients who received equal volume of normal saline as a placebo three times a week for six months. Laboratory tests were performed at baseline, then monthly until the end of the study. A significant increase in the hemoglobin (Hb) and hematocrit (HCT) in the presence of unchanged doses of erythropoietin hormonal supplementation was observed (pre 79 +/- 7.5 gm/l, post 103 +/- 10.6 gm/l) P< 0.001 (pre 24+/- 2 %, post 33 +/- 4%) P< 0.001 respectively) in the L-Carnitine treated group. Similarly total serum cholesterol (TCL) and serum triglyceride (TG) levels showed a statistically significant decrease in the study group, TCL (pre 4.6 +/- 1.2, post 3.7 +/- 1.1 mmol/L), P < 0.03 and TG (pre 3.1 +/- 1.7, post 1.8 +/- 0.6 mmol/L) P < 0.004. The physical performance as assessed by mild and moderate exercise showed a trend towards improvement. There was a significant increase in free carnitine and total carnitine levels in the L-Carnitine treated group. In conclusion, these results demostrate positive effect of L-Carnitine supplementation in the hemodialysis patients marked by an increase in Hb, HCT, a decrease in TCL and TG and improved physical performance in comparison to the control group.
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