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Nutrients 2014, 6(12), 5992-6004; doi:10.3390/nu6125992

Effects of Levocarnitine on Brachial-Ankle Pulse Wave Velocity in Hemodialysis Patients: A Randomized Controlled Trial

1
Department of Nephrology, Keiai Hospital, Tokyo 173-0036, Japan
2
Division of Nephrology, Hypertension and Endocrinology, Department of Internal Medicine, Nihon University School of Medicine, 30-1 Oyaguchi Kami-cho, Itabashi-ku, Tokyo 173-8610, Japan
3
Department of Cardiology, Keiai Hospital, Tokyo 173-0036, Japan
4
Department of Nephrology, Meirikai Chuo General Hospital, Tokyo 114-0001, Japan
*
Author to whom correspondence should be addressed.
Received: 27 October 2014 / Revised: 27 November 2014 / Accepted: 12 December 2014 / Published: 22 December 2014
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Abstract

Background and Aims: Atherosclerotic cardiovascular disease is the most common cause of mortality in patients with end-stage kidney disease. Chronic kidney disease patients often exhibit a deficiency in l-carnitine due to loss during hemodialysis (HD). We studied the effects of l-carnitine supplementation on brachial-ankle pulse wave velocity (baPWV), a marker of atherosclerosis, in HD patients. Methods: This was a prospective, open-label, randomized, parallel controlled, multi-center trial testing the anti-atherosclerotic efficacy of oral l-carnitine administration (20 mg/kg/day). HD patients (n = 176, mean age, 67.2 ± 10.3 years old; mean duration of HD, 54 ± 51 months) with plasma free l-carnitine deficiency (<40 μmol/L) were randomly assigned to the oral l-carnitine group (n = 88) or control group (n = 88) and monitored during 12 months of treatment. Results: There were no significant differences in baseline clinical variables between the l-carnitine and control groups. l-carnitine supplementation for 12 months significantly increased total, free, and acyl carnitine levels, and reduced the acyl/free carnitine ratio. The baPWV value decreased from 2085 ± 478 cm/s at baseline to 1972 ± 440 cm/s after six months (p < 0.05) to 1933 ± 363 cm/s after 12 months (p < 0.001) of l-carnitine administration, while no significant changes in baPWV were observed in the control group. Baseline baPWV was the only factor significantly correlated with the decrease in baPWV. Conclusions: l-carnitine supplementation significantly reduced baPWV in HD patients. l-carnitine may be a novel therapeutic strategy for preventing the progression of atherosclerotic cardiovascular disease. View Full-Text
Keywords: atherosclerosis; brachial-ankle pulse wave velocity; carnitine; end-stage kidney disease; hemodialysis atherosclerosis; brachial-ankle pulse wave velocity; carnitine; end-stage kidney disease; hemodialysis
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Higuchi, T.; Abe, M.; Yamazaki, T.; Mizuno, M.; Okawa, E.; Ando, H.; Oikawa, O.; Okada, K.; Kikuchi, F.; Soma, M. Effects of Levocarnitine on Brachial-Ankle Pulse Wave Velocity in Hemodialysis Patients: A Randomized Controlled Trial. Nutrients 2014, 6, 5992-6004.

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