Effects of oral L-carnitine administration in haemodialyzed patients

Intravenous L-carnitine has recognized effects in chronic haemodialyzed (HD) patients; the experience with oral L-carnitine is limited. A randomized controlled trial aimed to assess the effects of 6 months oral L-carnitine on anaemia correction, lipid metabolism and nutritional status in HD patients. 40 subjects with haemoglobin (Hb) < 10.5g/dL, without known causes of erythropoietin (Epo) hyporesponsiveness were enrolled and randomized in 2 groups: the carnitine group (n=20) received oral L-car-nitine, 6g/day and the control group (n=20) did not. After 6 months, Hb increased (8.6 +/- 0.9 vs 10.2 +/- 0.9 g/dL) only in carnitine group. A higher percentage of carnitine-treated patients reached target Hb (60 vs. 27%). Epoetin Resistance Index decreased with 18.2% in carnitine-treated subjects vs 11.1% in controls (p > 0.05). In the carnitine group, LDL cholesterol decreased (93.7 +/- 19.7 vs 78.8 +/- 23.1 mg/dL) and serum albumin increased (4.2 +/- 0.3 vs. 4.4 +/- 0.3g/dL). There were no changes in other parameters of the nutritional status. No adverse events were noted. Oral L-carnitine seems to improve anaemia response to Epo and to ameliorate the lipid profile and the nutritional status in HD patients.