THE INFLUENCE OFl-CARNITINE SUPPLEMENTATION ON HEMATOCRIT AND HEMOGLOBIN LEVELS IN PATIENTS WITH END STAGE RENAL FAILURE ON CAPD

Abstract

The influence of L-carnitine supplementation on hematocrit (Hct) and hemoglobin (Hb) levels, in patients suffering from end stage renal disease (ESRD) on maintenance hemodialysis, are well known from several studies. The data concerning the serum levels of carnitine, in patients with ESRD on continuous ambulatory peritoneal dialysis (CAPD) are contradictory, but most of them support that they are rather normal. In this study the effect of L-carnitine supplementation on Hct, and Hb levels were investigated in patients suffering from ESRD on CAPD. In the study 12 patients were included (5F, 7M), aged from 39 to 92 years old (median 65.5 years), who were on CAPD for more than 6 months (from 6 to 15 months, mean +/- SD = 8.6 +/- 3.6), with normal serum ferrum and ferritin levels at the beginning of the study. Two grams of L-carnitine/ day per os (Superamin, Vianex Hellas), were administered in all the patients and the serum ferrum levels were tried to be kept stable, by exogenous ferrum administration, during the study period. If the Hct levels were more than 36% per month the erythropoietin (rHuEpo) dose of the patient was decreased monthly at the half dose/week. The changes of Hct, Hb, ferrum and ferritin levels, as well as the Indice de Rigidite (IR) of the erythrocytes were recorded, before and after the first, second and third month of the study period. Finally, the rHuEpo dose/ patient was registered monthly before and during the study. During the observations, Hct (35.4 +/- 3.3 vs. 38.1 +/- 3.4, ANOVA, p < 0.03) and Hb levels (11.0 +/- 1.1 vs. 11.9 +/- 1, ANOVA, p < 0.01), were significantly increased. On the other hand, rHuEpo dose necessity/patient/week was decreased significantly (3,833 +/- 3326 vs. 1,292 +/- 1,712, ANOVA, p < 0.01), in order to succeed the target Hct level. Furthermore, red blood cells IR also appeared to have a significant decrease (16.6 +/- 7.4 vs. 13.0 +/- 3.9, paired t-test, p < 0.03). Finally, the ferrum and ferritin levels were stable during the study period. It was concluded, that in patients on, CAPD the per os L-carnitine supplementation decreased, the red blood cells IR which contributes to the: (a) Increase of Hct and Hb levels and (b) decrease of the patients rHuEpo dose/week.

Chronic hepatitis C-associated thrombocytopenia: aetiology and management

“…Recently, Lcarnitine has been proposed as a potential adjuvant treatment to improve anaemia, thrombocytopenia, leukopenia and immunological function. [68][69][70][71][72][73] In a recent study, L-carnitine added to Peg-IFN-α plus ribavirin led to less decrease of platelet count during antiviral therapy. 74 Some studies indicate that L-carnitine modulates platelet functions and production through antioxidant mechanisms and the inhibition of the arachidonic acid cascade.…”

Effect of combination therapy of hydroxyurea with l‐carnitine and magnesium chloride on hematologic parameters and cardiac function of patients with β‐thalassemia intermedia

“…The next approach for the pharmacotherapy of thalassemia intermedia is to use drugs that stimulate the synthesis of fetal hemoglobin (HbF), including hydroxyurea and derivatives of butyric acid (10)(11)(12)(13)(14)(15)(16)(17)(18). Hydroxyurea is a well-known chemotherapeutic agent that has been used largely for the treatment of various myeloproliferative conditions.…”

Improvement of Cardiac Function in Thalassemia major Treated with <i>L</i>-Carnitine

“…Previous studies have shown that L -carnitine supplementation in patients with heart disease secondary to iron overload may result in significant improvement in myocardial contractility [9, 10]. In addition, some studies have shown that L -carnitine also improves the hemoglobin level [11]. …”