title: Potential nephroprotective effects of l-carnitine against drug-induced nephropathy: a review of literature.
abstract: BACKGROUND
  Drug-induced nephrotoxicity (DIN) has been reported with a great number of medications and contributes to ∼ 20% of hospital admissions. l-carnitine owing to its antioxidant, anti-inflammatory and antiapoptotic properties has been proposed as a candidate for nephroprotection against DIN. Increasing need to use nephrotoxic therapeutic agents necessitated this review.
  
  
  METHODS
  The present review covers all published clinical and animal researches on nephroprotective effects of l-carnitine against DIN. l-carnitine significantly ameliorates DIN in animal studies especially against cisplatin-induced renal damage. Inhibition of reactive oxygen species generation, lipid peroxidation, matrix remodeling and apoptosis, anti-inflammatory properties and improvement in carnitine deficiency has been suggested as probable nephroprotective mechanisms of l-carnitine.
  
  
  CONCLUSIONS
  In spite of the evidences that support the nephroprotective effect of l-carnitine, the main problems in this area are inadequacy of reliable studies in humans and difficulty of translating the experimental results into clinical practice. In most of the described studies, l-carnitine treatment is prophylactically given. Use of l-carnitine as a prophylactic agent in clinical situations with an indication for nephrotoxic therapies is rarely possible except for contrast-induced nephrotoxicity. Development of validated early biomarkers to detect DIN may provide the opportunity to use prophylactic nephroprotective agents at golden time.
authors: Tehran University of Medical Science, Resident of Clinical Pharmacy, Faculty of Pharmacy, Tehran, Iran.
authors: Atefeh
authors: A
authors: Jafari
authors: Simin
authors: S
authors: Dashti-Khavidaki
authors: Hossein
authors: H
authors: Khalili
authors: Mahboob
authors: M
authors: Lessan-Pezeshki
mesh_terms: D000818:Animals; D002331:Carnitine / Q000494:pharmacology* / Q000627:therapeutic use*; D006801:Humans; D007668:Kidney / Q000187:drug effects* / Q000473:pathology; D007674:Kidney Diseases / Q000139:chemically induced* / Q000188:drug therapy* / Q000473:pathology
chemical_list: D002331:Carnitine