Journal of Isfahan Medical School

Journal of Isfahan Medical School

The Effect of Oral L-carnitine on Serum Albumin and Inflammatory Markers Levels in Patients under Peritoneal Dialysis: A Randomized Controlled Trial

Document Type : Original Article(s)

Authors
Mojgan Mortazavi 1
Sahel Asgari 2
Maryam Ghassami 3
Shiva Seirafian 1
Shahram Taheri 1
Afsoon Emami Naini 1
Afrooz Eshaghian 3
Ali Gholamrezai 3
Leila Fayaz 2
Shirin Karimi 4
1 Assistant Professor, Department of Nephrology, Isfahan Kidney Disease Center, Isfahan University of Medical Sciences, Isfahan, Iran.
2 Resident, Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
3 General Practitioner, Research, Student Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
4 Nurse, Peritoneal Dialysis Center, Isfahan Kidney Disease Center, Isfahan University of Medical Science, Isfahan, Iran.
Abstract
Background: Malnutrition is one of the most common complications among patients under maintenance dialysis which is related to systemic inflammatory processes. Decrease in serum albumin level, following malnutrition, is an independent risk factor for cardio-vascular diseases in patients under dialysis. We aimed to evaluate the effect of oral L-Carnitine supplementation on serum albumin and inflammatory factors (C reactive protein (CRP) and hemosysteine) in patients under peritoneal dialysis.Methods: This randomized, double-blind, placebo-controlled trial was conducted on 48 patients under peritoneal dialysis referring to Isfahan Peritoneal Dialysis Center from 2009-2010. Patients were randomized to carnitine and placebo groups and received oral carnitine (250 mg, 3 tablets /day) or placebo for 9 months. Serum albumin level was checked every 3 months and serum CRP and hemosysteine levels were checked before and after the study and compared between the two groups.Finding: Compared to placebo group, serum albumin level was increased significantly from 3.30 ± 0.51 to 3.70 ± 0.53 mg/dl (P = 0.044). In carnitine group, serum CRP level was increased from 2.35 ± 2.49 to 3.37 ± 4.80 mg/l (P = 0.304) while in the placebo group it was significantly increased from 1.37 ± 1.28 to 2.44 ± 2.68 mg/l (P = 0.039). In contrast, serum hemosysteine level was significantly increased in the carnitine group from 21.40 ± 8.08 to 25.70 ± 6.85 µgr/l (P = 0.019) while its increase in the placebo groop was not significant (P = 0.159). One patient in the carnitine group with history of hypertension experienced an increase in blood pressure that was controlled with a greater dose of anti-hypertensive drugs. Conclusion: In patients under peritoneal dialysis, oral L-carnitine can increase serum albumin level and prevent CRP rising, but has no beneficial effect on hemosysteine. According to several reports on beneficial effects of L-carnitine on anemia and lipid profile in patients under dialysis, its supplementation is recommended for these patients. 
Keywords
L-carnitine
Albumin
Systemic Inflammation
Malnutrition
Peritoneal dialysis
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Journal of Isfahan Medical School
Volume 29, Issue 138 - Serial Number 138
March and April 2011
Pages 546-554

  • Receive Date 21 November 2010
  • Accept Date 06 April 2022