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[L-carnitine therapy and myocardial function in children treated with chronic hemodialysis]
A E Khoss1, H Steger, E Legenstein
1Universitäts-Kinderklinik, Wien.
Insights
L-carnitine supplementation improved left ventricular function in children undergoing chronic hemodialysis. This intervention also reduced dialysis-related spasms and polyneuropathic symptoms, enhancing overall physical ability.
Area of Science:
- Cardiology
- Nephrology
- Biochemistry
Context:
- Children undergoing chronic hemodialysis often exhibit decreased serum carnitine levels.
- Carnitine deficiency can impact cardiac function and contribute to neurological symptoms.
Purpose:
- To evaluate the effects of L-carnitine supplementation on left ventricular function in children with chronic kidney disease on hemodialysis.
- To assess the impact of L-carnitine on dialysis-associated symptoms and overall physical capacity.
Summary:
- Six children with chronic hemodialysis and low carnitine levels received L-carnitine (15-30 mg/kg/day).
- Echocardiographic parameters (shortening fraction, LVPT/LVET ratio, Vcf) were monitored monthly.
- L-carnitine substitution led to significant improvements in left ventricular function, with a 44% mean improvement after 18 months.
Impact:
- L-carnitine supplementation demonstrates a positive effect on cardiac performance in pediatric hemodialysis patients.
- The treatment was well-tolerated, with no observed side effects.
- Patients reported reduced spasms, polyneuropathy, and increased somatic ability, improving quality of life.
Abstract:
Six out of 14 chronically hemodialysed children with significantly decreased serum carnitine levels were substituted with L-carnitine (15-30 mg/kg/day-Biocarn) up to normal and above normal carnitine levels. None of these patients were digitalised. During the time of investigation plasma carnitine levels were investigated monthly and, simultaneously, three echocardiographic parameters in M-mode were quantitatively und qualitatively determined: shortening fraction (SF-%), ratio of left ventricular pre-ejection/ejection time (LVPT/LVET) and velocity of circumferential fibre shortening (Vcf). Carnitine substitution produced measurable changes in echocardiographic parameters, and a significant quantitative improvement in left ventricular function and performance: after 6 months of carnitine substitution a 24% improvement was seen, after 18 months a 44% mean improvement. No side effects of carnitine were observed; the compatibility was good. Beside these positive effects all patients reported decreased dialysis-associated spasms and polyneuropathic symptoms and increased somatic ability.