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Open AccessArticle

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.
Nutrients 2014, 6(12), 5992-6004; https://doi.org/10.3390/nu6125992
Received: 27 October 2014 / Revised: 27 November 2014 / Accepted: 12 December 2014 / Published: 22 December 2014
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
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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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