QUALITY-OF-LIFE DURING AND BETWEEN HEMODIALYSIS TREATMENTS - ROLE OF L-CARNITINE SUPPLEMENTATION

End-stage renal disease affects every aspect of a patient's life, incl uding perception of health and quality of life. It is likely that a he modialysis patient's perceptions of health-related quality of life dir ectly influence compliance with medical, nursing, and nutritional pres criptions. Because L-carnitine supplementation is known to enhance mus cle strength and energy in hemodialysis patients, we hypothesized that L-carnitine supplementation would enhance a hemodialysis patient's pe rception of health-related quality of life. To test this hypothesis, 1 g L-carnitine or placebo was administered orally to 101 patients imme diately before and after every hemodialysis treatment for 6 months. To assess health-related quality of life from the patient's perspective, the Medical Outcomes Study Short Form 36 instrument was administered before the study and at 1.5-month intervals for the duration of the st udy. In addition, a 10-item questionnaire designed to assess common in tradialytic symptoms was administered at the end of each dialysis trea tment. Other parameters analyzed included Kt/V-urea and level of nutri tion. In the 6-month group, oral L-carnitine supplementation had an ea rly positive effect on general health (P < 0.02) and physical function (P < 0.03), but the perceived effect was not sustained throughout the 6 months of the study, In the 3-month group, L-carnitine supplementat ion improved vitality (P < 0.02) and general health (P < 0.01). There was no association between Kt/V-urea and perceived health-related qual ity of life. Serum albumin concentration was directly correlated to ho w patients perceived the quality of their lives. (C) 1998 by the Natio nal Kidney Foundation, Inc.