• Contact us
  • E-Submission

Ewha Med J : The Ewha Medical Journal

OPEN ACCESS
mobile search button mobile menu button
Search
Advanced Search
ABOUT
BROWSE ARTICLES
JOURNAL POLICIES
FOR CONTRIBUTORS

Articles

Page Path

Original Article

The Effects of Carnitine Supplementation in Hemodialysis Patients

Seung-Jung Kim
The Ewha Medical Journal 2012;35(2):89-94. Published online: September 30, 2012

Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.

Corresponding author: Seung-Jung Kim, Department of Internal Medicine, Ewha Womans University School of Medicine, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul 158-710, Korea. Tel: 82-2-2650-2648, Fax: 82-2-2655-2076, sjkimwon@ewha.ac.kr
• Received: July 27, 2012   • Accepted: August 17, 2012

Copyright © 2012. Ewha Womans University School of Medicine

  • 30 Views
  • 0 Download
prev

Full Article

Download PDF Download PDF
  • Objectives
    Patients receiving hemodialysis have been shown to be carnitine deficient due to many causes. Tissues, especially the skeletal muscle and myocardium, require carnitine for the production of energy. This study was performed to find out the effects of L-carnitine supplementation on muscular symptoms and cardiac functions in dialysis patients.
  • Methods
    Among 72 hemodialysis patients, 40 patients who showed decreased free carnitine levels were selected to receive L-carnitine intravenously after each hemodialysis session for 6 months. Before and after supplementation, echocardiography, various neurologic examinations and questionnaires were obtained.
  • Results
    After carnitine treatment for 6 months (1~1.5 g per every hemodialysis session), the blood level of carnitine was increased more than 10 times (19.04±7.12 µmol/L vs. 267.24±69.94 µmol/L, P<0.001). The left ventricular ejection fraction was improved in the patients who have less than 60% of ejection fraction (56.45±2.53% vs. 60.44±6.29%, P=0.03) after carnitine treatment. The neurological symptom score and isometric muscle power (pinch power) were improved, but the total neuropathy score, activities of daily living scale and grip power were not changed after carnitine supplementation on dialysis patients.
  • Conclusion
    Regular L-carnitine supplementation on hemodialysis patients can improve their left ventricular ejection fraction and some parts of functionality.
  • Keywords: Cardiac function; Carnitine; Hemodialysis; Neuropathy
  • 1. USRDS: US Renal Data System. Am J Kidney Dis 2003;42:6 Suppl 5. 1-230.
  • 2. Evans AM, Faull R, Fornasini G, Lemanowicz EF, Longo A, Pace S, et al. Pharmacokinetics of L-carnitine in patients with end-stage renal disease undergoing long-term hemodialysis. Clin Pharmacol Ther 2000;68:238-249.
  • 3. Schreiber B. Levocarnitine and dialysis: a review. Nutr Clin Pract 2005;20:218-243.
  • 4. Fritz IB. Carnitine and its role in fatty acid metabolism. Adv Lipid Res 1963;1:285-334.
  • 5. Chazot C, Laurent G, Charra B, Blanc C, VoVan C, Jean G, et al. Malnutrition in long-term haemodialysis survivors. Nephrol Dial Transplant 2001;16:61-69.
  • 6. Rocchi L, Feola I, Calvani M, D'Iddio S, Alfarone C, Frascarelli M. Effects of carnitine administration in patients with chronic renal failure undergoing periodic dialysis, evaluated by computerized electromyography. Drugs Exp Clin Res 1986;12:707-711.
  • 7. Ahmad S, Robertson HT, Golper TA, Wolfson M, Kurtin P, Katz LA, et al. Multicenter trial of L-carnitine in maintenance hemodialysis patients. II. Clinical and biochemical effects. Kidney Int 1990;38:912-918.
  • 8. Brass EP, Adler S, Sietsema KE, Hiatt WR, Orlando AM, Amato A. Intravenous L-carnitine increases plasma carnitine, reduces fatigue, and may preserve exercise capacity in hemodialysis patients. Am J Kidney Dis 2001;37:1018-1028.
  • 9. Siami G, Clinton ME, Mrak R, Griffis J, Stone W. Evaluation of the effect of intravenous L-carnitine therapy on function, structure and fatty acid metabolism of skeletal muscle in patients receiving chronic hemodialysis. Nephron 1991;57:306-313.
  • 10. van Es A, Henny FC, Kooistra MP, Lobatto S, Scholte HR. Amelioration of cardiac function by L-carnitine administration in patients on haemodialysis. Contrib Nephrol 1992;98:28-35.
  • 11. Romagnoli GF, Naso A, Carraro G, Lidestri V. Beneficial effects of L-carnitine in dialysis patients with impaired left ventricular function: an observational study. Curr Med Res Opin 2002;18:172-175.
  • 12. Matsumoto Y, Sato M, Ohashi H, Araki H, Tadokoro M, Osumi Y, et al. Effects of L-carnitine supplementation on cardiac morbidity in hemodialyzed patients. Am J Nephrol 2000;20:201-207.
  • 13. Sakurabayashi T, Miyazaki S, Yuasa Y, Sakai S, Suzuki M, Takahashi S, et al. L-carnitine supplementation decreases the left ventricular mass in patients undergoing hemodialysis. Circ J 2008;72:926-931.
  • 14. Oh JY, Kim SJ. Effects of L-carnitine supplementation on anemia in patients undergoing hemodialysis. Korean J Med 2006;71:285-292.
  • 15. Sohn HJ, Choi GB, Yoon KI. L-carnitine in maintenance hemodialysis clinical, lipid and biochemical effects. Korean J Nephrol 1992;11:260-269.
  • 16. Yoon HR, Hong YM, Boriack RL, Bennett MJ. Effect of L-carnitine supplementation on cardiac carnitine palmitoyltransferase activities and plasma carnitine concentrations in adriamycin-treated rats. Pediatr Res 2003;53:788-792.
  • 17. Dyck PJ, Bushek W, Spring EM, Karnes JL, Litchy WJ, O'Brien PC, et al. Vibratoty and cooling detection thresholds compared with other tests in diagnosing and staging diabetic neuropathy. Diabetes Care 1987;10:432-440.
  • 18. Cornblath DR, Chaudhry V, Carter K, Lee D, Seysedadr M, Miernicki M, et al. Total neuropathy score validation and reliability study. Neurology 1999;53:1660-1664.
  • 19. Schwab R, England A. Gillingham J, Donaldson L. Projection technique for evaluating surgery in Parkinson's disease. Third symposium on Parkinson's disease 1969;Edinburgh, UK, Livingston. 152-157.
  • 20. Painter P, Messer-Rehak D, Hanson P, Zimmerman SW, Glass NR. Exercise capacity in hemodialysis, CAPD, and renal transplant patients. Nephron 1986;42:47-51.
  • 21. Ifudu O, Mayers J, Matthew J, Tan CC, Cambridge A, Friedman EA. Dismal rehabilitation in geriatric inner-city hemodialysis patients. JAMA 1994;271:29-33.
  • 22. Johansen KL. Physical functioning and exercise capacity in patients on dialysis. Adv Ren Replace Ther 1999;6:141-148.
  • 23. Rogerson ME, Rylance PB, Wilson R, De Sousa C, Lanigan C, Rose PE, et al. Carnitine and weakness in haemodialysis patients. Nephrol Dial Transplant 1989;4:366-371.
  • 24. Semeniuk J, Shalansky KF, Taylor N, Jastrzebski J, Cameron EC. Evaluation of the effect of intravenous L-carnitine on quality of life in chronic hemodialysis patients. Clin Nephrol 2000;54:470-477.
  • 25. Stack AG, Bloembergen WE. A cross-sectional study of the prevalence and clinical correlates of congestive heart failure among incident US dialysis patients. Am J Kidney Dis 2001;38:992-1000.
  • 26. Trespalacios FC, Taylor AJ, Agodoa LY, Bakris GL, Abbott KC. Heart failure as a cause for hospitalization in chronic dialysis patients. Am J Kidney Dis 2003;41:1267-1277.
  • 27. Sakurabayashi T, Takaesu Y, Haginoshita S, Takeda T, Aoike I, Miyazaki S, et al. Improvement of myocardial fatty acid metabolism through L-carnitine administration to chronic hemodialysis patients. Am J Nephrol 1999;19:480-484.
  • 28. Fagher B, Cederblad G, Monti M, Olsson L, Rasmussen B, Thysell H. Carnitine and left ventricular function in haemodialysis patients. Scand J Clin Lab Invest 1985;45:193-198.
Fig. 1
Isometric muscle power. Pinch power is improved after supplementation of L-carninine, but grip power is not changed (*P=0.002).
emj-35-89-g001.jpg
Fig. 2
Neurological symptom score is improved after 6 month-carnitine treatment (*P=0.002).
emj-35-89-g002.jpg
Fig. 3
The mean left ventricular ejection fraction of total patients is not changed after L-carnitine supplementation (A, n=35). However, the left ventricular ejection fraction is improved in the patients who have less than 60% of ejection fraction (B, n=11) (*P=0.03).
emj-35-89-g003.jpg
Fig. 4
The changes of left ventricular ejection fractions among 11 patients who have less than 60% of ejection fraction.
emj-35-89-g004.jpg
Table 1
The level of total, free and acyl carnitines in dialysis patients
emj-35-89-i001.jpg

Figure & Data

References

    Citations

    Citations to this article as recorded by  

      Download Citation

      Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.

      Format:

      Include:

      The Effects of Carnitine Supplementation in Hemodialysis Patients
      Ewha Med J. 2012;35(2):89-94.   Published online September 30, 2012
      DOI: https://doi.org/10.12771/emj.2012.35.2.89
      Download Citation
      Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.
      Format:
      • RIS — For EndNote, ProCite, RefWorks, and most other reference management software
      • BibTeX — For JabRef, BibDesk, and other BibTeX-specific software
      Include:
      • Citation for the content below
      The Effects of Carnitine Supplementation in Hemodialysis Patients
      Ewha Med J. 2012;35(2):89-94.   Published online September 30, 2012
      DOI: https://doi.org/10.12771/emj.2012.35.2.89
      Close

      Figure

      • 0
      • 1
      • 2
      • 3
      The Effects of Carnitine Supplementation in Hemodialysis Patients
      Image Image Image Image
      Fig. 1 Isometric muscle power. Pinch power is improved after supplementation of L-carninine, but grip power is not changed (*P=0.002).
      Fig. 2 Neurological symptom score is improved after 6 month-carnitine treatment (*P=0.002).
      Fig. 3 The mean left ventricular ejection fraction of total patients is not changed after L-carnitine supplementation (A, n=35). However, the left ventricular ejection fraction is improved in the patients who have less than 60% of ejection fraction (B, n=11) (*P=0.03).
      Fig. 4 The changes of left ventricular ejection fractions among 11 patients who have less than 60% of ejection fraction.

      Fig. 1

      Fig. 2

      Fig. 3

      Fig. 4

      The Effects of Carnitine Supplementation in Hemodialysis Patients

      The level of total, free and acyl carnitines in dialysis patients
      Table 1 The level of total, free and acyl carnitines in dialysis patients

      Table 1

      Ewha Med J : The Ewha Medical Journal

      ABOUT

      BROWSE ARTICLES 

      JOURNAL POLICIES

      FOR CONTRIBUTORS 

      © Ewha Womans University College of Medicine.
      TOP