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혈액투석을 받는 만성 신부전 환자에서 L-carnitine 의 임상적 효과
손희정,윤건일,최규곱 대한신장학회 1992 Kidney Research and Clinical Practice Vol.11 No.3
Previous studies have reported conflicting results of carnitine supplementations on plasma lipids, clinical and biochemical effects in patients with chronic renal failure. We therefore performed a double-blind placebo controlled trial to evaluate the effects of post- hemodialysis intravenous injection of L-carnitine in ESRD patients on maintenance hemodialysis. The trial which lasted two months (baseline, 2 months treatment) was double blind placebo controlled and randomized. Thirty longterm hemodialysis patients, were given carnitine (n=15) or placebo (N=15), completed this study. In each group, clinical lipid and biochemical parameters during treatment were compared with baseline values. Fifteen patients received up to 2 months of L-carnitine infusion ($gt;50 kg; 1.5 g, $lt;50 kg; 1 g) and 15 received placebo infusion (0.9% normal saline). The results were as follows: 1) There were no significant changes observed in plasma triglyceride, HDL-cholesterol or other lipoprotein parameters except free fatty acid in either the carnitine or placebo treated group, Free fatty acid decreased signifiantly in the carnitine treated group (p $lt; 0.005). 2) Intradialytic hypotension and muscle cramp were reduced only in the carnitine treated group (p$lt;0.05). 3) No significant change was observed in serum urea nitrogen, creatinine or inorganic phosphorus in the car- nitine or placebo treated groups. 4) Mid-arm circumference and triceps skinfold thick- ness were measured in all patients. No significant changes in any of these variables were noticed in either carnitine or placebo treated group. In conclusion, intravenous L-carnitine in hemodialysis patients appear to be associated with decrease in dialytic symptoms, sense of well-being and free fatty acid, not associated with any major effects on other lipid profiles.
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