Effects ofL-Carnitine supplement on plasma coagulation and anticoagulation factors in hemodialysis patients

Abstract

Background: Hypercoagulability is an important risk factor for thrombosis and its complications in hemodialysis patients. This study was designed to investigate the effects of L-carnitine supplement on plasma coagulation and anticoagulation factors in hemodialysis patients. Methods: Thirty-six hemodialysis patients were randomly assigned to either a carnitine or a placebo group. Patients in the carnitine group received 1000 mg/day oral L-carnitine for 12 weeks, whereas patients in the placebo group received a corresponding placebo. At baseline and the end of week 12, 5 mL blood was collected after a 12-to 14-hour fast and plasma fibrinogen concentration, activity of plasma protein C, coagulation factors V, VII, IX, and serum concentrations of tissue plasminogen activator (tPA), plasminogen activator inhibitor type-1 (PAI-1), free carnitine, and C-reactive protein (CRP) were measured. Results: In the carnitine group, mean serum free carnitine concentration increased significantly to 150% of baseline (p < 0.001), whereas plasma fibrinogen and serum CRP had 98 mg/dL (p < 0.01) and 41% (p < 0.01) significant decreases, respectively, at the end of week 12 compared with baseline. The reductions were significant compared with the placebo group (p < 0.05). No significant differences were observed between the two groups with regard to mean changes of the activity of plasma protein C, coagulation factors V, VII, IX, and serum PAI-1 to tPA ratio. Conclusion: L-Carnitine supplement reduces serum CRP, a marker of systemic inflammation, and plasma fibrinogen, an inflammation-related coagulation factor, in hemodialysis patients. Therefore, L-carnitine may play an effective role in preventing cardiovascular diseases in these patients.

Effect of L-Carnitine Supplementation on Circulating C-Reactive Protein Levels: A Systematic Review and Meta-Analysis / Uticaj Suplementacije L-Karnitinom Na Nivoe C-Reaktivnog Proteina U Cirkulaciji: Sistematski Pregled I Metaanaliza

“…Thirteen articles were provisionally selected for further full-text evaluation. Out of these 13 publications, 6 met the inclusion criteria and were used for data extraction ( 19 – 24 ). The reasons for the exclusion of the remaining 7 articles were being not original ( n =2) ( 31 , 32 ), investigation of intravenous L-carnitine ( n =2) ( 18 , 33 ), publication in languages other than English ( n =2) ( 34 , 35 ), and lack of sufficient data on serum CRP status ( n =1) ( 36 ) ( Figure 1 ).…”

“…Measurement of serum CRP was carried out using either the particle-enhanced immunoturbidimetry ( 19 – 21 ) or enzyme-linked immunosorbent assay ( 22 – 24 ).…”

“…The pooled population of included studies comprised 1087 individuals, of which 541 were classified as the case group and 546 as the control group. Three studies were conducted in diabetic or prediabetic patients ( 19 , 20 , 22 ), 2 studies in hemodialysis patients ( 23 , 24 ) and 1 study in patients with non-alcoholic steatohepatitis ( 21 ). All studies were double-blind and placebo controlled apart from that of Shakeri et al which had an open-label design ( 25 ).…”

Current Experience in Testing Mitochondrial Nutrients in Disorders Featuring Oxidative Stress and Mitochondrial Dysfunction: Rational Design of Chemoprevention Trials

“…As shown in Table 3 , out of 74 evaluated studies, 18 clinical trials (of which 16 controlled trials) tested the effects of CARN in kidney diseases, treating a total of 427 patients with end-stage renal disease under hemodialysis, based on the rationale that CARN levels sharply decrease during hemodialysis, thus impairing response to recombinant human erythropoietin (rHuEPO) [ 181 , 184 , 204 , 205 , 206 , 207 , 208 , 209 , 210 , 211 , 212 , 213 , 214 , 215 , 216 , 217 , 218 , 219 , 220 ]. One study utilized both CARN and CoQ10—separately or in association—finding positive effects of both supplements, yet without evidence for improvement effects following combined supplementation [ 184 ].…”

Hemodialysis Adequacy Sacrificed for Business: A Qualitative Study

“…The high prevalence of symptoms such as fatigue (11), anorexia (12), sleep disorders (13), nausea and vomiting (14), peptic ulcer disease (15), itching (16), blood coagulation disorders (17), hyperparathyroidism (18), infection (19), dysgeusia (20), and blood pressure fluctuations due to inadequate dialysis can undermine the quality of life. Previous studies pinpointed several factors as barriers to adequate dialysis, namely patient -related factors (e g, hypotension, intradialytic symptoms, treatment time missed due to noncompliance or transportation problems, duration < 4 hours, blood flow rate (BFR) < 350 mL/minute, patient weight > 100 kg, and delivered BFR 50 mL/minute less than the prescribed BFR) and technical factors (e g, dialysis prescription, type of vascular access, clotting, and dialyzer reuse) (21)(22)(23).…”