1. Effects of Reducing L-Carnitine Supplementation on Carnitine Kinetics and Cardiac Function in Hemodialysis Patients: A Multicenter, Single-Blind, Placebo-Controlled, Randomized Clinical Trial
- Author
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Makoto Nasu, Yoshifumi Wada, Ryo Shibata, Yuka Kurokawa, Yusuke Kaida, Tomofumi Moriyama, Takuma Hazama, Kyoko Tashiro, Yukie Kinoshita, Yoshihiko Otsubo, Junko Yano, Kei Fukami, Goh Kodama, Kaoru Nakano, Takuya Ariyoshi, Ryuji Iwatani, Kengo Urae, and Miki Sugiyama more...
- Subjects
Male ,medicine.medical_treatment ,030232 urology & nephrology ,heart failure ,030204 cardiovascular system & hematology ,Gastroenterology ,0302 clinical medicine ,end-stage kidney disease ,Natriuretic peptide ,Single-Blind Method ,TX341-641 ,Prospective Studies ,hemodialysis ,Nutrition and Dietetics ,Decreased plasma carnitine ,Heart ,Middle Aged ,Brain natriuretic peptide ,Female ,Hemodialysis ,free fatty acid ,medicine.drug ,Cardiac function curve ,medicine.medical_specialty ,medicine.drug_class ,brain natriuretic peptide ,Placebo ,Article ,acylcarnitine ,03 medical and health sciences ,Renal Dialysis ,Carnitine ,Internal medicine ,medicine ,Humans ,Aged ,Dose-Response Relationship, Drug ,Nutrition. Foods and food supply ,business.industry ,CPT2 ,medicine.disease ,carnitine deficiency ,Heart failure ,Dietary Supplements ,Kidney Failure, Chronic ,cardiac function ,business ,cardiomyopathy ,Follow-Up Studies ,Food Science - 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. more...
- Published
- 2021
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