Intravenous pamidronate for refractory rheumatoid arthritis

Abstract

• BACKGROUND: Atherosclerosis is the leading cause of death in hemodialysis patients. These patients are also highly prone to L-carnitine deficiency due to kidney disease. In this clinical trial, we investigated the effect of oral L-carnitine on the endothelial function of these patients.
• METHODS: We studied 31 adult chronic hemodialysis patients in our center and divided them into two groups, a group of 20 patients who received 1500 mg/dialysis interval (every other day) oral L-carnitine and a control group of 11 patients who received placebo for one month. Ultrasonographic measurement of flow mediated dilation and carotid intima media thickness were performed before and after one month of L-carnitine and Placebo therapy.
• RESULTS: This study showed that after one month of L-carnitine or placebo therapy there was no significant improvement in flow mediated dilation ( p = 0.80, p=0.59 respectively) or decrease in carotid intima media thickness ( p = 0.12, p = 0.50 respectively). 
• CONCLUSIONS: Our study revealed that one month oral L-carnitine therapy does not improve endothelial function in hemodialysis patients. Long term studies with a large sample size using intravenous form and higher doses of the drug are required to clarify the questionable role of L-Carnitine in hemodialysis patients.
• KEYWORDS: Flow-mediated-dilation, Carotid-intima-media-thickness, Endothelial Dysfunction, Chronic Renal Failure, L-carnitine