Fatih University Medical School, Department of Nephrology, Ankara, Turkey.
Ren Fail. 2010 Jan;32(2):157-61. doi: 10.3109/08860221003592812.
Respiratory functions are affected during hemodialysis. The strength of respiratory muscles, ultrafiltration rate, and acid-base balance have been suggested as important factors. L-carnitine is crucial for energy producing, utilization of fatty acid, and possible amino acids. A lack of carnitine in hemodialysis patients is caused by insufficient carnitine synthesis and especially by its loss during dialysis. This study was performed to investigate the chronic effects of L-carnitine treatment on respiratory functions in adults receiving chronic hemodialysis therapy.
A total of 20 hemodialysis patients were scheduled to take L-carnitine supplementation (20 mg/kg three times/week) (group 1), and the rest of 20 hemodialysis patients served as the control group and were observed without supplementation with L-carnitine (group 2). Pre- and post-dialytic L-carnitine levels and post-dialytic respiratory functions tests were performed in both groups at baseline and after six months.
The average concentration of free and total carnitine levels increased significantly after six months of supplementation (p < 0.01). While a statistically significant increase between postdialytic forced expiratory volume in one second/forced vital capacity values after treatment period (77.10 +/- 12.15 and 83.00 +/- 14.49, before and after treatment, respectively, p < 0.05) was observed, the increase of vital capacity, forced expiratory volume in one second, and forced expiratory flow between 25-75% of expired vital capacity were not significant in the treatment group (p > 0.05).
Intravenous L-carnitine supplementation could contribute to the management of respiratory dysfunction in chronic hemodialysis patients by improving FEV1/FVC. The mechanism by which LC causes these effects merits further investigation.
血液透析过程中会影响呼吸功能。呼吸肌肉力量、超滤率和酸碱平衡被认为是重要因素。左旋肉碱对于产生能量、利用脂肪酸和可能的氨基酸至关重要。血液透析患者肉碱缺乏是由于肉碱合成不足，特别是透析过程中丢失所致。本研究旨在探讨左旋肉碱治疗对慢性血液透析患者呼吸功能的长期影响。
共 20 例血液透析患者接受左旋肉碱补充治疗（20mg/kg，每周 3 次）（1 组），其余 20 例血液透析患者作为对照组，不补充左旋肉碱（2 组）。两组患者均在基线和 6 个月时进行透析前和透析后左旋肉碱水平及透析后呼吸功能检查。
补充 6 个月后，游离肉碱和总肉碱浓度均显著升高（p<0.01）。治疗后用力呼气量/用力肺活量（FEV1/FVC）值（77.10±12.15 和 83.00±14.49，治疗前后）显著升高（p<0.05），但肺活量、用力呼气量、用力呼气流量在 25%至 75%肺活量之间无显著变化（p>0.05）。
静脉注射左旋肉碱补充可能通过改善 FEV1/FVC 来改善慢性血液透析患者的呼吸功能障碍。LC 引起这些作用的机制值得进一步研究。
