Intravenous L-carnitine increases plasma carnitine, reduces fatigue, and may preserve exercise capacity in hemodialysis patients.

摘要: Exercise capacity in patients with end-stage renal disease (ESRD) remains impaired despite correction of anemia. Carnitine insufficiency may contribute to exercise and functional capacities ESRD. Two randomized placebo-controlled trials were conducted test whether intravenous L-carnitine improves (assessed by maximal rate oxygen consumption [VO(2max)]) quality life (measured the Kidney Disease Questionnaire [KDQ]) In study A, administered L-carnitine, 20 mg/kg (n = 28), or placebo 28) intravenously at conclusion each thrice-weekly dialysis session for 24 weeks. B, a dose-ranging study, 10 32), 30), 40 33) as A. The prospective primary statistical analysis evaluated changes VO(2max) specified that KDQ assessed only combined populations. L-Carnitine supplementation increased plasma carnitine concentrations, but did not affect either study. Because change showed significant heterogeneity, secondary using mixture linear models approach on populations was performed. therapy (combined all doses) associated statistically smaller deterioration (-0.88 +/- 0.26 versus -0.05 0.19 mL/kg/min, respectively; P 0.009). significantly improved fatigue domain after 12 (P 0.01) weeks 0.03) treatment compared total score 0.10) other domains instrument > 0.11). well tolerated, no drug-related adverse effects identified. Intravenous patient-assessed fatigue, prevent decline peak hemodialysis patients. end points unaffected therapy.