L-carnitine in haemodialysed patients. Changes in lipid pattern.

Carnitine is a selective carrier of free fatty acids from the cytoplasm to the mitochondria. Dialysed patients are chronically and progressively carnitine deficient due to loss in the dialysate. Simultaneously such patients present impaired lipid metabolism and this may provoke varied pathological conditions ranging from isolated hypertriglyceridaemia to frank forms of hyperlipoproteinaemia types IIa, IIb, and IV, and to apparently normolipaemic situations falling within a lipoprotein pattern tending to become pathological with low levels of HDL-cholesterol. In the present investigation we evaluated the effect of l-carnitine (versus placebo) on the lipid pattern in a group of apparently normolipaemic dialysed patients, but with altered coronary risk factors (HDL-cholesterol, beta:alpha lipoprotein ratio). Examinations showed no significant changes at the 15th and 30th day of placebo treatment, whereas the l-carnitine treated group displayed a statistical significant increase in HDL-cholesterol accompanied by reduced pre-beta-lipoproteins and decreased beta:alpha ratio.