Associations of oral L-carnitine with hemoglobin, lipid profile, and albumin in hemodialysis patients

Abstract

• BACKGROUND: Previous reports have suggested acute phase proteins, such as albumin, to alter in hemodialysis (HD) patients. Intravenous L-carnitine supplementation is expected to improve the level of plasma albumin in HD patients. This study was performed to evaluate the effects of oral L-carnitine supplementation on hemoglobin, lipid profile, and albumin in HD patients.
• METHODS: In a double-blind, placebo-controlled study during October 2008 to April 2010, 54 HD patients were randomly assigned into 3 groups to receive 750 mg/day oral L-carnitine (17 patients), placebo (19 patients), or nothing (control group, 18 patients) for 6 months. Eligible patients for the study were above 21 years old, had no carnitine during the previous month, and had signed the informed consent to enter the study. The primary outcome was plasma albumin level. The secondary outcomes were hemoglobin level, erythropoietin (EPO) doses, lipid profile [high-density lipoprotein (HDL), low-density lipoprotein (LDL), cholesterol, and triglyceride), and side effects of L-carnitine.  Patients were followed for side effects. The results were analyzed by SPSS17.
• RESULTS: Before administration of L-carnitine, the mean levels of hemoglobin were 10.81 ± 1.20 mg/dl in the L-carnitine group, and 9.85 ± 1.13 mg/dl in the placebo group. At the end of the study, hemoglobin level was 11.6 ± 1.05 mg/dl in the L-carnitine group and 10.33 ± 1.08 mg/dl in the placebo group. Therefore, hemoglobin levels rose significantly in the L-carnitine group (p = 0.04) but not in the placebo group (p > 0.05). HDL decreased in the placebo group but had no changes in the L-carnitine group. Cholesterol, triglyceride, and LDL did not change during 6 months (p > 0.05). Side effects did not increase in the L-carnitine group.
• CONCLUSIONS: Administration of 750 mg/day oral L-carnitine for 6 months had beneficial effects on hemoglobin and HDL, but not on albumin and the required EPO. Studies with higher doses of oral L-carnitine or in peritoneal dialysis patients are suggested.
• KEYWORDS: L-Carnitine; Kidney Failure; Chronic; Acute-Phase Proteins