Effects of Levocarnitine on Nutritional and Microinflammatory State in Maintenance Hemodialysis Patients_West China Medical Journal

Authors：

 YuWuzhong , GaoGuosheng

Department of Nephrology, the Central Hospital of Ezhou, Ezhou, Hubei 436000, P. R. China;

Corresponding author：

Keywords：

Levocarnitine; Maintenance hemodialysis; Inflammation; Nutrition

DOI：

10.7507/1002-0179.20160007

Video：

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Objective To observe the effects of levocarnitine by intravenous injection on nutritional and microinflammatory state in maintenance hemodialysis patients. Methods Between October 2010 and October 2011, 62 maintenance hemodialysis (>6 months) patients in our dialysis center were enrolled in this study, and were randomly divided into treatment group (n=32) and control group (n=30). Patients in the treatment group were injected with levocarnitine (1.0 g once) after every dialysis for 3 months, while patients in the control group only accepted routine hemodialysis therapy. Blood biochemical indicators, serum high sensitive C-reactive protein (hs-CRP) were measured and compared at the experiment onset and 3 months later. Results After treatment with levocarnitine for three months, the average serum levels of albumin (Alb), hemoglobin (Hb), triacylglycerol (TG), high density lipoprotein cholesterol (HDL-C) and hs-CRP, and the conditions of dialysis hypotension, muscular spasm, lacking in strength, and anorexia were significantly different between the two groups (P<0.05). But there was no significant difference in total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) between the two groups (P>0.05). For the control group, after treatment, Alb, Hb and condition of anorexia changed significantly (P<0.05), while TC, TG, LDL-C, HDL-C, hs-CRP, conditions of dialysis hypotension, muscular spasm and lacking of strength did not change (P>0.05); for the treatment group, after treatment, all Alb, Hb, TG, HDL-C, hs-CRP, conditions of dialysis hypotension, muscular spasm, lacking of strength and anorexia changed significantly (P<0.05), while TC and LDL-C did not change obviously (P>0.05). Conclusion Levocarnitine can significantly improve the nutritional and microinflammatory state and better the quality of life in maintenance hemodialysis patients.

Citation： YuWuzhong, GaoGuosheng. Effects of Levocarnitine on Nutritional and Microinflammatory State in Maintenance Hemodialysis Patients. West China Medical Journal, 2016, 31(1): 25-28. doi: 10.7507/1002-0179.20160007 Copy

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10.	Savica V, Calvani M, Benatti P, et al. Carnitine system in uremic patients:molecular and clinical aspects[J]. Semin Nephrol, 2004, 24(5):464-468.
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12.	Guarnieri G, Biolo G, Vinci P, et al. Advances in carnitine in chronic uremia[J]. J Ren Nutr, 2007, 17(1):23-29.
13.	Reddy V, Bhandari S, Seymour AM, et al. Energy, provision, and carnitinie deficiency in experimental uremia[J]. J Am Soc Nephrol, 2007, 18(1):84-92.
14.	Cheng TH, Lam DH, Ting SK, et al. Serial monitoring of nutritional status in Chinese peritoneal dialysis patients by Subjective Global Assessment and comprehensive Malnutrition Inflammation Score[J]. Nephrology (Carlton), 2009, 14(2):143-147.
15.	Brass EP, Adler S, Sietsema KE, et al. Intravenous L-carnitine increases plasma carnitine, reduces fatigue, and may preserve exercise capacity in hemodialysis patients[J]. Am J Kidney Dis, 2001, 37(5):1018-1028.
16.	王爽, 毛英丽, 李亮, 等. 左卡尼汀及饮食干预对维持性血液透析患者营养不良的影响[J]. 临床肾脏病杂志, 2013, 13(1):19-21.
17.	贾慧, 薛军, 屠春林, 等. 左旋卡尼汀在维持性血液透析患者中的应用[J]. 现代中西医结合杂志, 2010, 19(1):34-35.
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1. Ritz E, Bommer J. Cardiovascular problems on hemodialysis:current deficits and potential improvement[J]. Clin J Am Soc Nephrol, 2009, 4(Suppl 1):S71-S78.
2. Liu BC, Li L, Gao M, et al. Microinflammation is involved in the dysfunction of arteriovenous fistula in patients with maintenance hemodialysis[J]. Chin Med J, 2008, 121(21):2157-2161.
3. Bellinghieri G, Santoro D, Calvani M, et al. Carnitine and hemodialysis[J]. Am J Kidney Dis, 2003, 41(3 Suppl 1):S116-S122.
4. 何朝生, 史伟, 梁馨苓, 等. 尿毒症患者微炎症状况与心血管事件的相关性研究[J]. 中国血液净化, 2008, 7(5):256-259.
5. Tsirpanlis G, Chatzipanagiotou S, Nicolaou C. Microinflammation versus inflammation in chronic renal failure patients[J]. Kidney Int, 2004, 66(5):2093-2094.
6. 陶静, 孙伟. 维持性血液透析患者与微炎症反应[J]. 肾脏病与透析肾移植杂志, 2011, 20(2):176-180.
7. Stenvinkel P. Inflammatory and atherosclerotic interactions in the depleted uremic patient[J]. Blood Purif, 2001, 19(1):53-61.
8. Abdel-Naeem NM, Kandell NF, El-Shamaa AA, et al. Biocompatible dialysis membranes and oxidative stress in patients wih end-stage renal disease on maintenance haemodialysis[J]. J Egypt Soc Parasitol, 2005, 35(3 Suppl):1173-1197.
9. Zoccali C, Tripepi G, Mallamaci F. Dissecting inflammation in ESRD:do cytokines and C-reactive protein have a complementary prognostic value for mortality in dialysis patients?[J]. J Am Soc Nephrol, 2006, 17(12 Suppl 3):S169-S173.
10. Savica V, Calvani M, Benatti P, et al. Carnitine system in uremic patients:molecular and clinical aspects[J]. Semin Nephrol, 2004, 24(5):464-468.
11. Pertosa G, Grandaliano G, Simone S, et al. Inflammation and carnitine in hemodialysis patients[J]. J Ren Nutr, 2005, 15(1):8-12.
12. Guarnieri G, Biolo G, Vinci P, et al. Advances in carnitine in chronic uremia[J]. J Ren Nutr, 2007, 17(1):23-29.
13. Reddy V, Bhandari S, Seymour AM, et al. Energy, provision, and carnitinie deficiency in experimental uremia[J]. J Am Soc Nephrol, 2007, 18(1):84-92.
14. Cheng TH, Lam DH, Ting SK, et al. Serial monitoring of nutritional status in Chinese peritoneal dialysis patients by Subjective Global Assessment and comprehensive Malnutrition Inflammation Score[J]. Nephrology (Carlton), 2009, 14(2):143-147.
15. Brass EP, Adler S, Sietsema KE, et al. Intravenous L-carnitine increases plasma carnitine, reduces fatigue, and may preserve exercise capacity in hemodialysis patients[J]. Am J Kidney Dis, 2001, 37(5):1018-1028.
16. 王爽, 毛英丽, 李亮, 等. 左卡尼汀及饮食干预对维持性血液透析患者营养不良的影响[J]. 临床肾脏病杂志, 2013, 13(1):19-21.
17. 贾慧, 薛军, 屠春林, 等. 左旋卡尼汀在维持性血液透析患者中的应用[J]. 现代中西医结合杂志, 2010, 19(1):34-35.
18. Gesuete V, Ragni L, Picchio FM. The "big heart" of carnitine[J]. G Ital Cardiol (Rome), 2010, 11(9):703-705.

West China Medical Journal

Effects of Levocarnitine on Nutritional and Microinflammatory State in Maintenance Hemodialysis Patients

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