L-carnitine effects on anemia in hemodialyzed patients treated with erythropoietin.
To demonstrate whether L-carnitine treatment could further improve the anemia in dialyzed patients under recombinant human erythropoietin (r-HuEPO) therapy, leading to a reduction in r-HuEPO requirements, L-carnitine (1 g intravenously after every dialysis session) was administered for 6 months to a group of 13 patients; the results were compared with data from a placebo control group (N = 11). Globular osmotic fragility and endogenous EPO secretion were also evaluated. L-Carnitine treatment promoted a 38.1% reduction in r-HuEPO requirements in the active group (102.2 +/- 52.6 U/kg/wk v 63.3 +/- 37.8 U/kg/wk; P < 0.02), with globular osmotic fragility and endogenous EPO levels remaining unchanged and thus not accounting for carnitine effect on anemia. In the active group, seven patients decreased r-HuEPO needs (responders), while six did not (nonresponders). Compared with nonresponders, responders showed higher mean values at time 0 for r-HuEPO requirements and endogenous plasma EPO levels, although not statistically significant. It is concluded that L-carnitine deficiency might promote EPO resistance in dialyzed patients, which is corrected by L-carnitine supplementation, ultimately reducing r-HuEPO requirements.
D000328:Adult; D000368:Aged; D000740:Anemia / Q000097:blood / Q000209:etiology / Q000378:metabolism / Q000628:therapy*; D002331:Carnitine / Q000627:therapeutic use*; D004921:Erythropoietin / Q000378:metabolism / Q000627:therapeutic use*; D005260:Female; D006400:Hematocrit; D006801:Humans; D007501:Iron / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009996:Osmotic Fragility; D006435:Renal Dialysis / Q000009:adverse effects*
D004921:Erythropoietin; D007501:Iron; D002331:Carnitine