Journal
JOURNAL OF NEPHROLOGY
Volume 27, Issue 3, Pages 317-329Publisher
SPRINGER HEIDELBERG
DOI: 10.1007/s40620-013-0002-7
Keywords
L-Carnitine; Effect; Hemodialysis; Meta-analysis
Categories
Funding
- National Natural Sciences Foundation of China [81270812, 81100541]
- Ph.D programs foundation of ministry of Education of China [2011062110012]
- Furong Scholars Fund from Hunan Province Education Department
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Background l-Carnitine has been used as adjuvant therapy in hemodialysis (HD) patients for many years. However, there is controversy whether l-carnitine supplementation is beneficial. Therefore we performed a meta-analysis of randomized controlled trials (RCTs) to assess the effect of l-carnitine on HD patients. Methods RCTs of l-carnitine versus placebo for HD patients were searched from Medline, EMBASE and the Cochrane Central Register of Controlled Trials. We screened relevant studies according to predefined inclusion and exclusion criteria, and performed meta-analyses using Revman 5.1 software. Results Meta-analysis showed l-carnitine could not increase the total score of 36-item Short-Form Health Survey Questionnaire (SF-36) (SMD 0.76, 95 % CI -0.13 to 1.65, P = 0.09), and l-carnitine therapy did not improve serum C-reactive protein (SMD -0.37, 95 % CI -0.88 to 0.14, P = 0.16), oxidized low-density lipoprotein (SMD 0.04, 95 % CI -0.43 to 0.50, P = 0.87), albumin (SMD 0.25, 95 % CI -0.31 to 0.81, P = 0.38;), hemoglobin (SMD 0.23, 95 % CI -0.23 to 0.68, P = 0.33), cholesterol (SMD -0.24, 95 % CI -0.71 to 0.24, P = 0.33), triglycerides (SMD 0.02, 95 % CI -0.4 to 0.44, P = 0.91) or parathyroid hormone (SMD 0.21, 95 % CI -0.35 to 0.76, P = 0.46) levels. Conclusions There is no evidence that l-carnitine can improve the inflammation, oxidative stress, nutrition, anemia, dyslipidemia, hyperparathyroidism status or quality of life in HD patients. However, given methodological limitations and lack of hard endpoints, high-quality, long-term randomized trials are required to fully elucidate the clinical value of l-carnitine administration in hemodialysis patients.
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