Effect of L-carnitine on protein catabolic rate (PCR) in chronic hemodialysis patients (CHD).
ASN 30th Annual Meeting, San Antonio
J Am Soc Nephrol (Sep) 8:189A 1997
L-carnitine facilitates the entry of long-chain fatty acids into mitochondria. Low plasma levels of L-carnitine is a consistent finding in chronic hemodialysis patients. Muscle carnitine levels have been found to be decreased or normal in chronic hemodialysis patients [1-3].
In this study L-carnitine was given to 20 stable chronic hemodialysis patients for 6 months. Eighteen patients completed the study. At completion there were no significant changes in dry weight, anthropometry, nor in the biochemical markers s-albumin, s-bicarbonate, s-phosphate, hematocrit, urea reduction ratio. However, the PCR (0.94 - 1.08 g/kg/day) and predialysis BUN (58.4 - 67.6 mg/dl) increased significantly (p<0.01). The effect was most marked in patients with a low PCR at the start.
Comment: The increase in PCR and predialysis BUN may be attributed to an increase in appetite during the study. Whether L-carnitine exerts such an effect is not known and the mechanism is not understood. The only means to elucidate the potential effects of L-carnitine supplementation is by conducting a randomized double-blind placebo-controlled study in chronic hemodialysis patients. (Peter F. Barany, M.D., Stockholm, Sweden)
1. Savica V, Bellinghieri G, Di Stefano C, Corvaja E, Consolo F, Corsi M, Maccari F, Spagnoli LG, Villaschi S, Palmieri G. Plasma and muscle carnitine levels in haemodialysis patients with morphological-ultrastructural examination of muscle samples. Nephron 35: 232-6, 1983.
2. Moorthy AV, Rosenblum M, Rajaram R, Shug AL. A comparison of plasma and muscle carnitine levels in patients on peritoneal or hemodialysis for chronic renal failure. Am J Nephrology 3: 205-8, 1983.
3. Vacha GM, Giorcelli G, d'Iddio S, Valentini G, Bagiella E, Procopio A, di Donato S. Ashbrook D, Corsi M. L-carnitine addition to dialysis fluid. A therapeutic alternative for hemodialysis patients. The abstract of this paper is available from the National Library of Medicine's PubMed site: Nephron 51(2):237-42, 1989.
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ASN 30th Annual Meeting, San Antonio
CRF by organ system : Nutrition