Hemodynamic Stabilizing Effects of L-Carnitine in Chronic Hemodialysis Patients

Abstract

Background: The effects of <smlcap>L</smlcap>-carnitine on the hemodynamic state of chronic hemodialysis patients have been debated. In order to clarify the effect of administered <smlcap>L</smlcap>-carnitine on cardiac function and hypotensive episodes during the hemodialysis procedure, a randomized double-blind placebo-controlled study was performed for 3 months. Methods and Results: Twenty stable outpatients undergoing hemodialysis treatment were divided into two groups: controls (placebo) and treated patients (<smlcap>L</smlcap>-carnitine 900 mg p.o. daily). After 3 months, cardiac function was reevaluated by echocardiography, and hypotensive episodes during hemodialysis were assessed. Free and acyl carnitine levels increased significantly from 22.3 ± 7.1 to 140.3 ± 57.5 μmol/l and from 15.8 ± 2.8 to 94.8 ± 50.4 μmol/l, respectively, in the treated group. The ejection fraction significantly increased from 61.8 ± 16.0 to 64.4 ± 13.8% (p < 0.05) in the treated group. However, there was no difference in other echocardiographic parameters between the two groups. Hypotensive episodes significantly decreased from 4.0 ± 1.7 to 1.3 ± 0.9 times per month (p < 0.05), although patients' body weight did not change significantly. Conclusions: Beneficial effects of <smlcap>L</smlcap>-carnitine on the hemodynamic state of chronic hemodialysis patients were observed. <smlcap>L</smlcap>-Carnitine supplementation might be considered especially for chronic hemodialysis patients with unstable hemodynamic conditions.