Clinical Research Effects of switching from oral administration to intravenous injection of L-carnitine on lipid metabolism in hemodialysis patients

Background. Carnitine deficiency may contribute to cardiovascular disease (CVD) in patients with hemodialysis (HD). Dyslipidemia plays a role in CVD and its prevalence is also high in HD patients. We examined here the effects of switching from oral administration (PO) to intravenous (IV) injec-tion of L-carnitine on lipid metabolism in patients with HD. Methods. Nine HD patients who had received L-carnitine orally (900 mg/day) for 1 year were enrolled in this study. We examined whether lipid parameters were improved by switching to IV injection therapy of 1000 mg L-carnitine. Results. IV injection of L-carnitine for 1 week significantly increased total, free and acyl carnitine levels both before and after HD. Switching to IV injection therapy for 1 and 4 weeks decreased serum free fatty acid (FFA) (322 ± 104 versus 261 ± 124 µmol/L) and increased high-density lipoprotein-cholesterol levels (1.46 ± 0.49 versus 1.63 ± 0.62 mmol/L), respectively. Change in FFA values from the baseline (ΔFFA) was positively correlated with the Δacyl/free carnitine ratio (r2 = 0.553, P = 0.022). Conclusion. This study demonstrated that switching to IV L-carnitine therapy from oral supplemen-tation improved lipid profiles, thus supporting the clinical utility of IV administration of L-carnitine for the treatment of patients on HD