Effects of L-carnitine supplementation on nutritional, immunological, and cardiac parameters in hemodialysis patients: a pilot studyReport as inadecuate




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Renal Replacement Therapy

, 1:3

First Online: 24 November 2015Received: 03 July 2015Accepted: 08 September 2015

Abstract

BackgroundL-carnitine is an essential compound that facilitates the transport of long-chain fatty acid across the inner mitochondrial membrane for β-oxidation. However, the effect of L-carnitine supplementation remains to be fully explored in patients with chronic kidney disease. We aimed in this study to determine the multidirectional effects of L-carnitine supplementation on clinical parameters in more detail.

MethodsWe orally administered L-carnitine to maintain serum-free carnitine levels within the normal range 30 to 70 μmol-L for 6 months in 21 hemodialysis HD patients age, 74 ± 11 years; time on HD, 60 ± 84 months.

ResultsL-carnitine supplementation significantly increased serum transferrin from 155 ± 41 to 175 ± 48 mg-dL p < 0.01 and retinol-binding protein from 8.9 ± 2.5 to 10.0 ± 3.4 mg-dL p < 0.05. The triceps skinfold thickness was also significantly increased p < 0.05, while the skeletal muscle mass in limbs and handgrip strength was not. L-carnitine enhanced natural killer NK cell activity at the E effector cell-T target cell ratio of 20:1 from 17.3 ± 14.1 to 20.8 ± 17.7 % p < 0.01. In addition, L-carnitine improved left ventricular functional shortening p < 0.01 with a significant decrease of brain natriuretic peptide BNP from 621.4 ± 666.8 to 412.0 ± 426.0 pg-mL p < 0.05.

ConclusionsThese findings suggest that oral L-carnitine treatment improves immunological and cardiac markers in HD patients. In contrast, L-carnitine did not change the skeletal mass-related parameters during the 6-month follow-up.

KeywordsHemodialysis L-carnitine Sarcopenia Natural killer cell activity Left ventricular function Abbreviations%CGRcreatinine generation rate

BIAbioelectrical impedance

BNPbrain natriuretic peptide

BWbody weight

CDcluster of differentiation

CKDchronic kidney disease

CRPC-reactive protein

CTcomputed tomography

CTRcardiothoracic ratio

DWdry weight

E-T ratioeffector cells-target cells ratio

EFejection fraction

FSfractional shortening

GNRIgeriatric nutritional risk index

HDhemodialysis

HDLhigh-density lipoprotein

Igimmunoglobulin

IL-6interleukin-6

IVSinterventricular septal thickness

LDLlow-density lipoprotein

LVDdleft ventricular end-diastolic dimension

LVDsleft ventricular end-systolic dimension

LVEDVleft ventricular end-diastolic volume

LVESVleft ventricular end-systolic volume

LVMleft ventricular mass

LVMIleft ventricular mass index

MACmidarm circumference

MAMCmidarm muscle circumference

NKnatural killer

nPCRnormalized protein catabolic rate

PEWprotein-energy wasting

PNIprognostic nutrition index

RRFCrate of reabsorption of free carnitine

sIL-2Rsoluble interleukin-2 receptor

TBAthigh bone area

TLCtotal lymphocyte count

TMAthigh muscle area

TSFtriceps skinfold thickness

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Author: Haruki Sada - Akihiko Kato - Ryo Sumimoto - Hiromitsu Ohmori - Hideki Ohdan

Source: https://link.springer.com/







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