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Abstract
It has been reported that cumulative carnitine losses through dialysis membranes may
worsen hyperlipidemia during long-term hemodialysis. However, carnitine supplementation
has not shown a consistent beneficial response. We undertook the present study to
determine if there is any hypolipidemic effect of L -carnitine on Greek dialysis
patients in concert with the dialysate buffer composition (acetate or bicarbonate).
A total of 28 patients (16 male, 12 female), mean age 43 years (range 21–61), with
end-stage renal disease on maintenance hemodialysis for a mean period of 25 months
(range 7–84) were studied. The dialysis schedule was 4 h, 3 times/week using cuprophane
hollow-fiber dialyzers and acetate (n = 14) or bicarbonate (n = 14) dialysate. In
all patients L -carnitine (5 mg/kg body weight) was infused intravenously 3 times/week
at the end of each hemodialysis session. Blood samples for carnitine and lipid determinations
were obtained before treatment, and 3 and 6 months following treatment. Even though
L -carnitine did not modify most of the serum lipid levels, a significant decrease
in serum triglycerides was evident in the whole group of patients (from 225 ± 76 to
201 ± 75 mg/dl, p = 0.03). Furthermore, L -carnitine could decrease serum triglycerides
only in hypertriglyceridemic patients (from 260 ± 64 to 226 ± 82 mg/dl, p < 0.05).
L -Carnitine resulted in a reduction of serum triglycerides in both patients on bicarbonate
and on acetate dialysis, while there were no significant differences in the changes
of lipid parameters after L -carnitine between the two groups of hemodialysis patients.
We conclude that relatively low doses of L -carnitine supplementation could contribute
to the management of some hypertriglyceridemic hemodialysis patients.