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Effects of L-carnitine on dialysis-related hypotension and muscle cramps: a meta-analysis

Katherine E Lynch1, Harold I Feldman, Jesse A Berlin

  • 1Renal-Electrolyte and Hypertension Division, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
|August 19, 2008
PubMed

Insights

L-Carnitine supplementation may help reduce dialysis-related muscle cramps in patients with end-stage renal disease. However, current evidence is insufficient to confirm its benefits for cramps or hypotension, necessitating further research.

Area of Science:

  • Nephrology
  • Clinical Pharmacology
  • Biochemistry

Background:

  • L-Carnitine is an endogenous compound with potential therapeutic applications.
  • Its use in dialysis patients for hypotension and muscle cramps lacks robust evidence.
  • End-stage renal disease (ESRD) patients undergoing hemodialysis often experience these complications.

Purpose of the Study:

  • To systematically review and meta-analyze randomized controlled trials (RCTs) on L-Carnitine supplementation.
  • To evaluate the efficacy of L-Carnitine in treating intradialytic hypotension and muscle cramps in ESRD patients.
  • To determine if current evidence supports L-Carnitine's use in this patient population.

Main Methods:

  • Systematic review and meta-analysis of published English-language RCTs.
  • Inclusion criteria: adult ESRD patients on long-term hemodialysis, L-Carnitine vs. placebo for ≥8 weeks.
  • Outcome measures: intradialytic cramping and hypotension.

Main Results:

  • Seven RCTs with 193 patients were included.
  • Pooled analysis showed a significant reduction in cramping (OR 0.30, P=0.05).
  • No significant effect was found for intradialytic hypotension (OR 0.28, P=0.2).

Conclusions:

  • Limited statistical power due to a small number of studies and patients.
  • Significant interstudy heterogeneity was observed.
  • While suggestive for muscle cramps, evidence does not confirm L-Carnitine's benefit for dialysis-related cramps or hypotension; larger trials are needed.
Abstract

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