Effects of oral or intravenous L-carnitine administration on serum carnitine levels and clinical parameters in hemodialysis patients

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  • Fukami Kei
    Division of Nephrology, Department of Medicine, Kurume University School of Medicine
  • Sakai Kazuko
    Division of Nephrology, Department of Medicine, Kurume University School of Medicine
  • Kaida Yusuke
    Division of Nephrology, Department of Medicine, Kurume University School of Medicine
  • Otsuka Aki
    Sugi Cardiovascular Hospital
  • Wada Yoshifumi
    Wada Cardiovascular Clinic
  • Sugi Kenzo
    Sugi Cardiovascular Hospital
  • Okuda Seiya
    Division of Nephrology, Department of Medicine, Kurume University School of Medicine

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Other Title
  • 血液透析患者に対する経口・静注L-カルニチン補充療法がカルニチン濃度に与える影響とその効果についての検討
  • ケツエキ トウセキ カンジャ ニ タイスル ケイコウ ・ ジョウチュウ L-カルニチン ホジュウ リョウホウ ガ カルニチン ノウド ニ アタエル エイキョウ ト ソノ コウカ ニ ツイテ ノ ケントウ

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Abstract

【Background and Aim】Carnitine deficiency may contribute to erythropoietin-resistant anemia and malnutrition, which could lead to impaired quality of life in patients with hemodialysis (HD). We examined here the effects of oral L-carnitine supplementation on renal anemia and malnutrition in HD patients. We also investigated whether switching from oral administration of L-carnitine to intravenous injection could affect serum carnitine levels in these patients.【Methods】One hundred and two HD patients (total carnitine levels<50μmol/L) were enrolled and randomized to either oral administration of L-carnitine (900 mg/day) (N=51) or control (N=51). After 6 months, anemia and clinical variables, including serum levels of carnitine, were measured. Three months after administration, serum carnitine levels were examined just before and after the HD session. Furthermore, oral L-carnitine administration was switched to intravenous injection (500 or 1,000 mg), and serum carnitine levels were examined.【Results】Oral L-carnitine supplementation for 6 months (n=23) significantly increased hematocrit, LDL-cholesterol, triglycerides, and all carnitine levels, while AST and ALT levels, and acyl/free carnitine ratio were decreased. Switching to intravenous injection therapy (1,000 mg) for 1 week dramatically increased all serum carnitine levels just before and after and 10 min after the injection. There was no change of carnitine levels by switching to 500 mg intravenous injection.【Conclusion】The present study demonstrated that oral L-carnitine supplementation might improve renal anemia and malnutrition in HD patients. Switching to intravenous injection may be beneficial as a result of increase in carnitine levels, improvement of adherence, cost-benefit, and reducing the production of trimethylamine-N oxide (TMAO).

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