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- Title
Effects of Reducing L-Carnitine Supplementation on Carnitine Kinetics and Cardiac Function in Hemodialysis Patients: A Multicenter, Single-Blind, Placebo-Controlled, Randomized Clinical Trial.
- Authors
Sugiyama, Miki; Hazama, Takuma; Nakano, Kaoru; Urae, Kengo; Moriyama, Tomofumi; Ariyoshi, Takuya; Kurokawa, Yuka; Kodama, Goh; Wada, Yoshifumi; Yano, Junko; Otsubo, Yoshihiko; Iwatani, Ryuji; Kinoshita, Yukie; Kaida, Yusuke; Nasu, Makoto; Shibata, Ryo; Tashiro, Kyoko; Fukami, Kei
- Abstract
L-carnitine (LC) supplementation improves cardiac function in hemodialysis (HD) patients. However, whether reducing LC supplementation affects carnitine kinetics and cardiac function in HD patients treated with LC remains unclear. Fifty-nine HD patients previously treated with intravenous LC 1000 mg per HD session (three times weekly) were allocated to three groups: LC injection three times weekly, once weekly, and placebo, and prospectively followed up for six months. Carnitine fractions were assessed by enzyme cycling methods. Plasma and red blood cell (RBC) acylcarnitines were profiled using tandem mass spectrometry. Cardiac function was evaluated using echocardiography and plasma B-type natriuretic peptide (BNP) levels. Reducing LC administration to once weekly significantly decreased plasma carnitine fractions and RBC-free carnitine levels during the study period, which were further decreased in the placebo group (p < 0.001). Plasma BNP levels were significantly elevated in the placebo group (p = 0.03). Furthermore, changes in RBC (C16 + C18:1)/C2 acylcarnitine ratio were positively correlated with changes in plasma BNP levels (β = 0.389, p = 0.005). Reducing LC administration for six months significantly decreased both plasma and RBC carnitine levels, while the full termination of LC increased plasma BNP levels; however, it did not influence cardiac function in HD patients.
- Subjects
TREATMENT of chronic kidney failure; RESEARCH; ECHOCARDIOGRAPHY; CARNITINE; CARDIOVASCULAR system physiology; INTRAVENOUS therapy; CARDIOMYOPATHIES; MEDICAL cooperation; DIETARY supplements; RANDOMIZED controlled trials; PLACEBOS; BLIND experiment; MASS spectrometry; DESCRIPTIVE statistics; HEMODIALYSIS; PEPTIDE hormones; ERYTHROCYTES; TERMINATION of treatment; LONGITUDINAL method; HEART failure
- Publication
Nutrients, 2021, Vol 13, Issue 6, p1900
- ISSN
2072-6643
- Publication type
Article
- DOI
10.3390/nu13061900