EFFECTS OF L-CARNITINE SUPPLEMENTATION ON MUSCULAR SYMPTOMS IN HEMODIALYZED PATIENTS

Various muscle symptoms are well recognized among patients on maintena nce hemodialysis, Carnitine deficiency may be an important factor of d ialysis-associated muscle symptoms, whereas high-dose L-carnitine supp lementation may result in unphysiologically high plasma levels of carn itine and carnitine esters. We studied the effect of low-dose L-carnit ine treatment (500 mg/d) on muscle symptoms, plasma carnitine fraction s, and lipid profiles in 30 periodically dialyzed patients with muscul ar weakness, fatigue, or cramps/aches. After 12 weeks of L-carnitine t reatment, about two-thirds of patients had at least some improvement i n muscular symptoms, whereas carnitine fractions were normal or slight ly above normal ranges, but lipid profiles showed no demonstrable chan ges. This study also showed the correlation between plasma-free carnit ine deficiency and months on dialysis, These results suggest that prol onged low-dose L-carnitine treatment can improve dialysis-associated m uscle symptoms by restoring carnitine tissue levels and washing out ac yl moieties. (C) 1998 by the National Kidney Foundation, Inc.