EFFECT OF CARNITINE SUPPLEMENTATION ON CARDIAC-FUNCTION IN HEMODIALYZED CHILDREN

Thirteen carnitine-deficient children (mean age, 16.1 +/- 2.56 years) on a three-times-weekly hemodialysis program for at least 1 year, and 11 healthy age matched children were involved in the study. All the pa tients had stable blood pressure and hemoglobin (Hb) levels with a mai ntenance dose of erythropoetin and none were digitalized. The total ca rnitine (TC) and free carnitine (FC) plasma levels were sampled prior to hemodialysis (HD) before and after 3 months of carnitine supplement ation. A free carnitine (FC) to acylcarnitine (AC) ratio less than 4 w as defined as carnitine deficiency. Intravenous L-carnitine was inject ed at a dose of 20-40 mg/kg three times weekly at the end of each dial ysis session for a 3-month period. Echocardiographic examination was p erformed the day following PID, before and after carnitine treatment. Systolic and diastolic functions of the left ventricle, including the ejection fraction, were measured. Almost all the parameters were signi ficantly different in controls and hemodialyzed patients. In carnitine -deficient hemodialyzed patients, 3 months of L-carnitine supplementat ion resulted in a significant increase in blood carnitine levels and t he FC/AC ratio, but this was not associated with any significant impro vement of cardiac function. Furthermore no significant changes were ob served in plasma triglycerides, total cholesterol or other lipoprotein parameters before or after carnitine supplementation. Although there was a moderate increase in mean hematocrit (Hct) and Hb levels, these also did not reach statistically significant levels. These results sug gest that the 3 months of carnitine supplementation is not sufficient to ameliorate cardiac function or increase Hb levels in children.