Hemodynamic Stabilizing Effects of L-Carnitine in Chronic Hemodialysis Patients

Background: The effects of L-carnitine on the hemodynamic state of chronic hemodialysis patients have been debated. In order to clarify the effect of administered L-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 (L-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 mu mol/l and from 15.8 +/- 2.8 to 94.8 +/- 50.4 mu mol/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 L-carnitine on the hemodynamic state of chronic hemodialysis patients were observed. L-Carnitine supplementation might be considered especially for chronic hemodialysis patients with unstable hemodynamic conditions. (C) 2013 S. Karger AG, Basel