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      L-carnitine effects on anemia in hemodialyzed patients treated with erythropoietin.

      American Journal of Kidney Diseases

      adverse effects, Renal Dialysis, Osmotic Fragility, Middle Aged, Male, therapeutic use, Iron, Humans, Hematocrit, Female, metabolism, Erythropoietin, Carnitine, therapy, etiology, blood, Anemia, Aged, Adult

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          Abstract

          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.

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