Hypothesis and Objectives:
The most common cause of morbidity and mortality in patients on chronic hemodialysis is cardiovascular disease. According to data from clinical studies, structural and functional alterations of the large arteries are contributing to the high cardiovascular mortality of these patients. A well accepted way for examining the stiffness of the large arteries is measuring the augmentation index (AIx).
L-carnitine supplementation in hemodialysis patients has beneficial effects on the lipid alterations and is improving cardiac function. There is no data on the effect of L-carnitine supplementation on the arterial stiffness.
The aim of the present study was to evaluate the effect of L-carnitine supplementation on the AIx of hemodialysis patients.
Patients and Methods:
Stable chronic hemodialysis patients (n = 22, age = 59+−13 years, male/female: 14/8) were supplemented with L-carnitine. 11 patients were normotensive, 11 patients were treated hypertensives. The patients medical and dialysis treatment was unchanged during the study period. Renal replacement therapy: hemodiafiltration 3x4 hours weekly using polysulphone membranes. L-carnitine supplementation: 1000 mg iv, after each dialysis treatmet for 9 weeks. Blood pressure measurements were performed with calibrated automatic devices. AIx was measured by applanation tonometry (SphygmoCor, AtCor Inc) prior to the respective dialysis treatment, before L-carnitine supplementation was started and at the end of the 9th week of supplementation.
Predialysis blood pressure measured at the beginning of the carnitine supplementation period and at its end was unchanged (129.3+−18.9/76.4+−10.9 vs 127.7+−12.7/75.2+−10.4 mmHg). The AIx was significantly lower at the end of the L-carnitine supplementation period than before it (30.24+−14.18% vs 35.86+−10.49%; p < 0.05).
L-carnitine supplementation is decreasing the stiffness of the large arteries in chronic hemodialysis patients. Besides its effect on lipid homeostasis and cardiac function, L-carnitine supplementation may decrease the cardiovascular morbidity and mortality of these patients by improving their vascular stiffness.