The effects of L-carnitine supplement on anemia in hemodialysis patients: A randomized clinical trial study

Anvar Mohammadi-Baneh, Ezat Rahimi, Ghobad Moradi, Zahed Mafakheri, Avin Khorshidi

DOI: 10.22122/cdj.v9i3.622


BACKGROUND: There is no general consensus about the effect of L-carnitine (LC) on anemic factors in hemodialysis patients. In this clinical trial, the effect of LC on anemia was investigated in these patients.

METHODS: In a double-blinded clinical trial, hemodialysis patients admitted to the dialysis department of Tohid Hospital in Sanandaj, Iran, in 2017, were randomly divided into two groups of intervention (n = 40) and placebo (n = 40). Individuals in the intervention group received a dose of 1 g/day of LC, and the other group received placebo tablets of the same form for 12 weeks. Anemia factors were evaluated in both groups before and after the intervention. The data were analyzed using t-test and analysis of covariance (ANCOVA).

RESULTS: The LC supplementation increased hemoglobin (Hb) in hemodialysis patients (P = 0.043). Moreover, the mean corpuscular volume (MCV) level was decreased under the effect of LC (P < 0.001). The mean ± standard deviation (SD) scores of ferritin serum level before and after the intervention were 528.43 ± 466.96 and 737.70 ± 468.38 μg/l, respectively. This indicates a significant difference from that of the placebo group (P < 0.001). The results showed that LC supplementation did not affect red cell distribution width (RDW), platelet count (PLT), mean platelet volume (MPV), iron (Fe), and total iron-binding capacity (TIBC) levels (P > 0.050).

CONCLUSION: The effect of LC supplement on Hb, serum ferritin, and MCV levels in hemodialysis patients was significant. Therefore, LC can be used to treat anemia in this group of patients.


L-carnitine; Hemodialysis; Anemia; Randomized Clinical Trial Study; Iran

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Kuwasawa-Iwasaki M, Io H, Muto M, Ichikawa S, Wakabayashi K, Kanda R, et al. Effects of L-Carnitine Supplementation in Patients Receiving Hemodialysis or Peritoneal Dialysis. Nutrients 2020; 12(11): 3371.

Fauc AS, Kasper DL, Hauser SL, Jameson JL, Longo DL, Loscalzo J. Harrison's Principles of internal medicine self-assessment and board review. New York, NY: McGraw-Hill Education; 2018.

Fishbane S, Spinowitz B. Update on anemia in ESRD and earlier stages of CKD: Core Curriculum 2018. Am J Kidney Dis 2018; 71(3): 423-35.

Nikolaos S, George A, Telemachos T, Maria S, Yannis M, Konstantinos M. Effect of L-carnitine supplementation on red blood cells deformability in hemodialysis patients. Ren Fail 2000; 22(1): 73-80.

Matsumoto Y, Amano I, Hirose S, Tsuruta Y, Hara S, Murata M, et al. Effects of L-carnitine supplementation on renal anemia in poor responders to erythropoietin. Blood Purif 2001; 19(1): 24-32.

Hurot JM, Cucherat M, Haugh M, Fouque D. Effects of L-carnitine supplementation in maintenance hemodialysis patients: A systematic review. J Am Soc Nephrol 2002; 13(3): 708-14.

Bellinghieri G, Santoro D, Calvani M, Mallamace A, Savica V. Carnitine and hemodialysis. Am J Kidney Dis 2003; 41(3 Suppl 1): S116-S122.

Kudoh Y, Aoyama S, Torii T, Chen Q, Nagahara D, Sakata H, et al. Long-term effects of oral L-carnitine supplementation on anemia in chronic hemodialysis. Cardiorenal Med 2014; 4(1): 53-9.

Bellinghieri G, Santoro D, Calvani M, Savica V. Role of carnitine in modulating acute-phase protein synthesis in hemodialysis patients. J Ren Nutr 2005; 15(1): 13-7.

Golper TA, Goral S, Becker BN, Langman CB. L-carnitine treatment of anemia. Am J Kidney Dis 2003; 41(4 Suppl 4): S27-S34.

Evans A. Dialysis-related carnitine disorder and levocarnitine pharmacology. Am J Kidney Dis 2003; 41(4 Suppl 4): S13-S26.

Labonia WD. L-carnitine effects on anemia in hemodialyzed patients treated with erythropoietin. Am J Kidney Dis 1995; 26(5): 757-64.

Kletzmayr J, Mayer G, Legenstein E, Heinz-Peer G, Leitha T, Horl WH, et al. Anemia and carnitine supplementation in hemodialyzed patients. Kidney Int Suppl 1999; 69: S93-106.

Esfahani FH, Asghari G, Mirmiran P, Azizi F. Reproducibility and relative validity of food group intake in a food frequency questionnaire developed for the Tehran Lipid and Glucose Study. J Epidemiol 2010; 20(2): 150-8.

Emami Naini A, Moradi M, Mortazavi M, Amini Harandi A, Hadizadeh M, Shirani F, et al. Effects of Oral L-Carnitine Supplementation on Lipid Profile, Anemia, and Quality of Life in Chronic Renal Disease Patients under Hemodialysis: A Randomized, Double-Blinded, Placebo-Controlled Trial. J Nutr Metab 2012; 2012: 510483.

Sabry AA. The role of oral L-carnitine therapy in chronic hemodialysis patients. Saudi J Kidney Dis Transpl 2010; 21(3): 454-9.

Wanic-Kossowska M, Kazmierski M, Pawliczak E, Kobelski M. Combined therapy with L-carnitine and erythropoietin of anemia in chronic kidney failure patients undergoing hemodialysis. Pol Arch Med Wewn 2007; 117(1-2): 14-9.

Kadiroglu AK, Yilmaz ME, Sit D, Kara IH, Isikoglu B. The evaluation of postdialysis L-carnitine administration and its effect on weekly requiring doses of rHuEPO in hemodialysis patients. Ren Fail 2005; 27(4): 367-72.

Najafi F, Taheri N. Effects of L-carnitine added to erythropoietin in anemic chronic renal failure patients on hemodialysis. J Shaheed Sadoughi Univ Med Sci 2006; 14(3): 31-7. [In Persian].

Verrina E, Caruso U, Calevo MG, Emma F, Sorino P, De Palo T, et al. Effect of carnitine supplementation on lipid profile and anemia in children on chronic dialysis. Pediatr Nephrol 2007; 22(5): 727-33.

Al-Fifi SH. Carnitine serum levels in children with iron deficiency anemia. The Medical Journal of Cairo University 2021; 79(2).

Ahmadi SE, Mozaffari-Khosravi H, Dehghan-Bnadaki S, Noori-majelan N, Lotfi MH. The effect of oral L-carnitine supplementation on lipid profiles and antioxidant status in hemodialysis patients: A randomized clinical trial. J Shaheed Sadoughi Univ Med Sci 2016; 24(1): 93-101. [In Persian].

Arduini A, Bonomini M, Clutterbuck EJ, Laffan MA, Pusey CD. Effect of L-carnitine administration on erythrocyte survival in haemodialysis patients. Nephrol Dial Transplant 2006; 21(9): 2671-2.

Higuchi T. Effects of levocarnitine on cardiac function and renal anemia in hemodialysis patients. Contrib Nephrol 2018; 196: 96-100.


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