In:
Clinical Journal of the American Society of Nephrology, Ovid Technologies (Wolters Kluwer Health), Vol. 7, No. 11 ( 2012-11), p. 1836-1842
Abstract:
L-carnitine levels decrease rapidly and steadily with duration of hemodialysis, and carnitine depletion can impair response to recombinant human erythropoietin (rHuEPO). The study hypothesis was that L-carnitine supplementation during the first year of hemodialysis would improve this response. Design, setting, participants, & measurements From October 2006 through March 2010, this multicenter, randomized, double-blinded study assigned 92 incident hemodialysis patients to receive placebo or 1 g of intravenous L-carnitine after each dialysis session for 1 year. The primary outcome measure compared the groups for rHuEPO resistance index (EPO-RI), defined as weekly rHuEPO doses (IU/kg body weight divided by hemoglobin level) (g/dl). Results In the L-carnitine group, carnitine concentration increased from a mean ± SD of 79±51 µmol/L to 258±137 µmol/L; in the placebo group, it declined from 68±25 µmol/L to 53±24 µmol/L (interaction group × time, P 〈 0.001). Carnitine deficiency affected about 30% of the patients in the placebo group during the study period. EPO-RI varied from 15.8±11.3 to 9.5±5.8 IU/kg per g/dl in the placebo group and from 20.6±12.8 to 15.6±15.9 IU/kg per g/dl in the L-carnitine group, for a mean variation of −3.94±12.5 IU/kg per g/dl and −2.98±15.5 IU/kg per g/dl, respectively ( P =0.7). After adjustment for baseline characteristics, the EPO-RI course was similar in each group (difference between groups, P =0.10; interaction group × time, P =0.9). Conclusions Carnitine levels decrease by about 11%±33% during the first year of hemodialysis. Treatment of incident hemodialysis patients with L-carnitine does not improve their response to rHuEPO.
Type of Medium:
Online Resource
ISSN:
1555-9041
DOI:
10.2215/CJN.12431211
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2012
detail.hit.zdb_id:
2216582-4
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