Propionyl-L-carnitine therapy: effects on endothelin-1 and homocysteine levels in patients with peripheral arterial disease and end-stage renal disease.
OBJECTIVE
Recent data have addressed the issue of higher levels of homocysteine (Hcy) and endothelin-1 (ET-1) in end-stage renal disease (ESRD) that may be considered an independent predictor for cardiovascular disease. The prevalence of peripheral arterial disease (PAD) in patients with ESRD has been reported to be relevant, highlighting its clinical importance. We aimed to explore the therapeutic role of propionyl-L-carnitine (PLC) in hemodialysis patients with PAD by measuring ankle/brachial index (ABI), ET-1 and Hcy.


METHODS
Randomized, double-blind, placebo-controlled trial.


METHODS
Sixty-four patients on hemodialysis with chronic renal insufficiency and PAD were assigned to receive either intravenous PLC (600 mg) or placebo 3 times weekly for 12 months. The ABI and plasma levels of ET-1 and Hcy were measured at baseline, 6 and 12 months.


RESULTS
In the PLC-treated group, progressive increases in ABI were observed, while in the placebo group the reverse trend was seen. Highly significant and progressive reductions in plasma levels of ET-1 and Hcy, compared to baseline, were also seen in the PLC-treated group.


CONCLUSIONS
Hemodynamic flow, endothelial profile and Hcy levels were ameliorated by the administration of PLC in hemodialysis patients with ESRD and PAD.
Signorelli
Salvatore Santo
SS
Medical Angiology Section, Department of Internal Medicine and Systemic Pathology, University of Catania, Catania, Italy. ssignore@unict.it
Fatuzzo
Pasquale
P
Rapisarda
Francesco
F
Neri
Sergio
S
Ferrante
Margherita
M
Oliveri Conti
Gea
G
Fallico
Roberto
R
Di Pino
Luigi
L
Pennisi
Giuseppe
G
Celotta
Gabriella
G
Anzaldi
Massimiliano
M
D000842:Ankle / Q000502:physiology; D001934:Branchial Region / Q000502:physiology; D002331:Carnitine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D004311:Double-Blind Method; D019332:Endothelin-1 / Q000097:blood*; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D007262:Infusions, Intravenous / Q000379:methods*; D007676:Kidney Failure, Chronic / Q000188:drug therapy*; D016491:Peripheral Vascular Diseases / Q000188:drug therapy*; D010919:Placebos; D006435:Renal Dialysis
D019332:Endothelin-1; D010919:Placebos; D006710:Homocysteine; C003223:propionylcarnitine; D002331:Carnitine