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Updated: Feb 24, 2026

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Levocarnitine Decreases Intradialytic Hypotension Episodes: A Randomized Controlled Trial.

Héctor Raúl Ibarra-Sifuentes1,2, Ángel Del Cueto-Aguilera1, Daniel Alberto Gallegos-Arguijo1

  • 1Department of Internal Medicine, Autonomous University of Nuevo León, University Hospital, Mexico.

Therapeutic Apheresis and Dialysis : Official Peer-Reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy
|August 15, 2017
PubMed
Summary

Levocarnitine supplementation effectively prevents intradialytic hypotension in hemodialysis patients with chronic kidney disease. This treatment reduces hypotension episodes, improving patient outcomes during dialysis.

Keywords:
CarnitineChronic kidney diseaseHemodialysisIntradialytic hypotension

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Area of Science:

  • Nephrology
  • Cardiovascular Medicine

Background:

  • Intradialytic hypotension (IDH) is a frequent complication in patients with stage 5 chronic kidney disease undergoing hemodialysis, affecting 15-30% of patients.
  • Levocarnitine deficiency is observed in these patients, potentially contributing to IDH.

Purpose of the Study:

  • To evaluate the efficacy of levocarnitine in preventing intradialytic hypotension.
  • To assess a novel administration method of levocarnitine prior to hemodialysis sessions.

Main Methods:

  • A randomized, placebo-controlled, quadruple-blinded trial involving 33 patients undergoing 1188 hemodialysis sessions.
  • Patients received either levocarnitine or a placebo 0 and 30 minutes before each dialysis session, respectively.

Main Results:

  • A total of 239 (21.3%) intradialytic hypotension episodes were recorded.
  • The incidence of IDH was significantly lower in the levocarnitine group (9.3%, 60 events) compared to the placebo group (P < 0.001).

Conclusions:

  • Pre-hemodialysis levocarnitine supplementation is an effective strategy to reduce intradialytic hypotension episodes.
  • This administration method represents a promising new approach for managing IDH in chronic kidney disease patients.