HDCN Abstract:  ASN Annual Meeting -- San Francisco  

Owen PJ, Chesterton L, Priestman WS, et al.

Intravenous L-Carnitine Supplementation Confers No Cardiovascular Benefit in Incident Haemodialysis Patients.

ASN Annual Meeting -- San Francisco
J Am Soc Nephrol (Nov) 18:710A 2007

AIM: Haemodialysis (HD) patients have an increased risk of cardiovascular disease and skeletal muscle myopathies. These have been linked to secondary depletion of carnitine. A decline in the incidence of cardiac arrhythmias and myocardial dysfunction have been reported in patients supplemented with L-Carnitine. Lack of myocardial contractile reserve is an important determinant of the haemodynamic response to haemodialysis. This study aimed to determine if intravenous supplementation of L-Carnitine confers measurable cardiovascular benefit in incident haemodialysis patients during their first year on haemodialysis.

METHODS: Eight incident haemodialysis patients were recruited and randomised to receive either 10mg/kg L-Carnitine i.v. or placebo following each HD session. Cardiovascular function was assessed whilst the patients were on HD at their initial HD session, at 6 months and at 12 months using pulse wave analysis (Finometer). This non-invasive procedure involves continuous monitoring of digital arterial pressure waveform and generates beat to beat information on blood pressure and the full range of cardiovascular functional indices. Muscle biopsy samples were obtained from subjects prior to their first dialysis and at 6 and 12 months for analysis of total carnitine (TC) content. The study groups were well matched for age and cause of end-stage-renal- disease.

RESULTS: Muscle TC remained stable in the treatment group but declined in the placebo group by 15% at 6 months and 20% in one patient at 12 months. No significant differences were observed between study groups or within study groups over the twelve month period for the measured parameters: systolic and diastolic blood pressures, mean arterial pressure, stroke volume, cardiac output, total peripheral resistance and heart rate.

CONCLUSION: L-Carnitine supplementation to prevent secondary depletion of muscle carnitine, does not provide any measurable benefit in cardiovascular function.

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