BACKGROUND: L-Carnitine is an endogenous compound thought to be helpful in treating patients with dialysis-related hypotension and muscle cramps; however, sufficient evidence for these indications is lacking. STUDY DESIGN: Systematic review and meta-analysis. SETTING & POPULATION: Adult patients with end-stage renal disease receiving long-term hemodialysis. SELECTION CRITERIA FOR STUDIES: All published English-language reports of randomized placebo-controlled trials of L-carnitine supplementation in adult long-term hemodialysis patients. INTERVENTION: Supplemental L-carnitine (or placebo) for at least 8 weeks. OUTCOME: Random-effects pooled odds ratio for intradialytic cramping or hypotension in L-carnitine-treated participants. RESULTS: Of 317 potentially relevant articles, 7 (total enrollment of 193 patients) met criteria for inclusion. Four articles reported results for both hypotension and cramps, 1 had results for only hypotension, and 2 reported results for only cramps. Using data from all 6 relevant trials, the pooled odds ratio for cramping after L-carnitine supplementation was 0.30 (95% confidence interval, 0.09 to 1.00; P = 0.05). Analysis of the 5 studies examining the response of intradialytic hypotension to l-carnitine supplementation yielded a pooled odds ratio of 0.28 (95% confidence interval, 0.04 to 2.23; P = 0.2). LIMITATIONS: The small number of available studies yielded limited statistical power. In addition, there was considerable interstudy heterogeneity. CONCLUSIONS: Although suggestive in the case of muscle cramping, the available evidence does not confirm a beneficial effect of L-carnitine supplementation on dialysis-related muscle cramping or intradialytic hypotension. Additional study in the form of large rigorous randomized trials is needed in both cases.
BACKGROUND:L-Carnitine is an endogenous compound thought to be helpful in treating patients with dialysis-related hypotension and muscle cramps; however, sufficient evidence for these indications is lacking. STUDY DESIGN: Systematic review and meta-analysis. SETTING & POPULATION: Adult patients with end-stage renal disease receiving long-term hemodialysis. SELECTION CRITERIA FOR STUDIES: All published English-language reports of randomized placebo-controlled trials of L-carnitine supplementation in adult long-term hemodialysis patients. INTERVENTION: Supplemental L-carnitine (or placebo) for at least 8 weeks. OUTCOME: Random-effects pooled odds ratio for intradialytic cramping or hypotension in L-carnitine-treated participants. RESULTS: Of 317 potentially relevant articles, 7 (total enrollment of 193 patients) met criteria for inclusion. Four articles reported results for both hypotension and cramps, 1 had results for only hypotension, and 2 reported results for only cramps. Using data from all 6 relevant trials, the pooled odds ratio for cramping after L-carnitine supplementation was 0.30 (95% confidence interval, 0.09 to 1.00; P = 0.05). Analysis of the 5 studies examining the response of intradialytic hypotension to l-carnitine supplementation yielded a pooled odds ratio of 0.28 (95% confidence interval, 0.04 to 2.23; P = 0.2). LIMITATIONS: The small number of available studies yielded limited statistical power. In addition, there was considerable interstudy heterogeneity. CONCLUSIONS: Although suggestive in the case of muscle cramping, the available evidence does not confirm a beneficial effect of L-carnitine supplementation on dialysis-related muscle cramping or intradialytic hypotension. Additional study in the form of large rigorous randomized trials is needed in both cases.
Authors: Api Chewcharat; Pol Chewcharat; Weitao Liu; Jacqueline Cellini; Elizabeth A Phipps; Jill A Melendez Young; Sagar U Nigwekar Journal: PLoS One Date: 2022-07-14 Impact factor: 3.752
Authors: Arthur V Iansavichus; R Brian Haynes; Christopher W C Lee; Nancy L Wilczynski; Ann McKibbon; Salimah Z Shariff; Peter G Blake; Robert M Lindsay; Amit X Garg Journal: Clin J Am Soc Nephrol Date: 2012-08-23 Impact factor: 8.237
Authors: Thomas A Golper; Rachel Fissell; William H Fissell; P Matthew Hartle; M Lee Sanders; Gerald Schulman Journal: Am J Kidney Dis Date: 2013-11-19 Impact factor: 8.860