title: Effect of L-carnitine therapy on patients in maintenance hemodialysis: a systematic review and meta-analysis.
abstract: BACKGROUND
  L-Carnitine has been used as adjuvant therapy in hemodialysis (HD) patients for many years. However, there is controversy whether L-carnitine supplementation is beneficial. Therefore we performed a meta-analysis of randomized controlled trials (RCTs) to assess the effect of L-carnitine on HD patients.
  
  
  METHODS
  RCTs of L-carnitine versus placebo for HD patients were searched from Medline, EMBASE and the Cochrane Central Register of Controlled Trials. We screened relevant studies according to predefined inclusion and exclusion criteria, and performed meta-analyses using Revman 5.1 software.
  
  
  RESULTS
  Meta-analysis showed L-carnitine could not increase the total score of 36-item Short-Form Health Survey Questionnaire (SF-36) (SMD 0.76, 95 % CI -0.13 to 1.65, P = 0.09), and L-carnitine therapy did not improve serum C-reactive protein (SMD -0.37, 95 % CI -0.88 to 0.14, P = 0.16), oxidized low-density lipoprotein (SMD 0.04, 95 % CI -0.43 to 0.50, P = 0.87), albumin (SMD 0.25, 95 % CI -0.31 to 0.81, P = 0.38;), hemoglobin (SMD 0.23, 95 % CI -0.23 to 0.68, P = 0.33), cholesterol (SMD -0.24, 95 % CI -0.71 to 0.24, P = 0.33), triglycerides (SMD 0.02, 95 % CI -0.4 to 0.44, P = 0.91) or parathyroid hormone (SMD 0.21, 95 % CI -0.35 to 0.76, P = 0.46) levels.
  
  
  CONCLUSIONS
  There is no evidence that L-carnitine can improve the inflammation, oxidative stress, nutrition, anemia, dyslipidemia, hyperparathyroidism status or quality of life in HD patients. However, given methodological limitations and lack of hard endpoints, high-quality, long-term randomized trials are required to fully elucidate the clinical value of L-carnitine administration in hemodialysis patients.
authors.affiliation: Kidney Institute of Nephrology, Central South University, Changsha, Hunan, China.
authors.forename: Shi-Kun
authors.initials: SK
authors.lastname: Yang
authors.forename: Li
authors.initials: L
authors.lastname: Xiao
authors.forename: Pan-Ai
authors.initials: PA
authors.lastname: Song
authors.forename: Xiaoxuan
authors.initials: X
authors.lastname: Xu
authors.forename: Fu-You
authors.initials: FY
authors.lastname: Liu
authors.forename: Lin
authors.initials: L
authors.lastname: Sun
mesh_terms: D015415:Biomarkers / Q000097:blood; D002331:Carnitine / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D006304:Health Status; D006801:Humans; D007668:Kidney / Q000187:drug effects* / Q000378:metabolism / Q000503:physiopathology; D007676:Kidney Failure, Chronic / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D006435:Renal Dialysis; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D002331:Carnitine