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Protein, malnutrition and wasting disorders

Efficacy of L-carnitine supplementation for improving lean body mass and physical function in patients on hemodialysis: a randomized controlled trial

European Journal of Clinical Nutrition volume 73, pages 293–301 (2019)Cite this article

Subjects

ABSTRACT

Background

Carnitine deficiency is common in patients on hemodialysis. However, the efficacy of L-carnitine supplementation for improving lean body mass (LBM) and physical function has not yet been evaluated.

Methods

In this multicenter, prospective, parallel, randomized, controlled trial, 91 patients on hemodialysis who developed carnitine deficiency were randomly assigned to receive injections of 1,000 mg L-carnitine 3 times per week after each hemodialysis session (L-carnitine group) or no injections (control group) with monitoring for 12 months.

Results

The data for 84 of the 91 patients were available for analysis (L-carnitine group, n = 42; control group, n = 42). Dry weight and body mass index did not significantly change in the l-carnitine group, but significantly decreased in the control group. Arm muscle area (AMA) did not change significantly in the L-carnitine group but decreased significantly in the control group; the difference in mean AMA between the groups was 6.22% (95% confidence interval [CI] 1.90–10.5; P = 0.037). Hand grip strength did not change significantly in the L-carnitine group, but decreased significantly in the control group. The difference in change in hand grip strength between the groups was 4.27% (95% CI 0.42–8.12; P = 0.030). Furthermore, LBM did not change significantly in the l-carnitine group but decreased significantly in the control group; the difference in mean LBM between the groups was 2.92 % (95% CI 1.28–4.61; P = 0.0007).

Conclusions

l-carnitine supplementation is useful in patients who develop carnitine deficiency on hemodialysis because it maintains physical function and LBM.

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Author contributions

Research concept and study design: TH, TM, NM. Acquisition of data: CN, HT, MK, KU, RT, TF, TY, EO. Data analysis and interpretation: TM, NM. Statistical analysis: TH, MA. Supervision or mentorship: HA, FK. Each author contributed significant intellectual content during drafting or revision of the manuscript and takes accountability for the overall work by ensuring appropriate investigation and resolution of questions pertaining to the accuracy or integrity of any aspect of this work.

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    Authors and Affiliations

    1. Division of Nephrology, Hypertension and Endocrinology, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan

      Takashi Maruyama, Noriaki Maruyama, Chinami Nagura, Hiroyuki Takashima, Maki Kitai, Kei Utsunomiya, Ritsukou Tei, Tetsuya Furukawa & Masanori Abe

    2. Department of Nephrology, Keiai Hospital, Tokyo, Japan

      Terumi Higuchi, Toshio Yamazaki & Erina Okawa

    3. Department of Cardiology, Keiai Hospital, Tokyo, Japan

      Hideyuki Ando

    4. Department of Nephrology, Meirikai Chuo General Hospital, Tokyo, Japan

      Fumito Kikuchi

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    Correspondence to Masanori Abe.

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    MA has received honoraria from Otsuka Pharmaceutical Co., Ltd. The other authors declare that they have no conflict of interest.

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    These authors contributed equally: Takashi Maruyama, Noriaki Maruyama

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    Maruyama, T., Maruyama, N., Higuchi, T. et al. Efficacy of L-carnitine supplementation for improving lean body mass and physical function in patients on hemodialysis: a randomized controlled trial. Eur J Clin Nutr 73, 293–301 (2019). https://doi.org/10.1038/s41430-018-0348-y

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