Levocarnitine Decreases Intradialytic Hypotension Episodes: A Randomized Controlled Trial

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.