Having this evidence s , the potential role of Carnitine in improving malnutrition consequences in CKD patients would be clearly defined
Protein energy malnutrition is a common problem in patients with chronic kidney disease ( CKD ) .
Scattered reports indicate that supplementation of Carnitine may improve patients ' clinical symptoms , with significant improvement in nutritional parameters .
This systematic review was done to document the evidence s of Carnitine effects in nutritional status of CKD patients .
Intravenous L-carnitine increases plasma carnitine, reduces fatigue, and may preserve exercise capacity in hemodialysis patients.
Exercise capacity in patients with end-stage renal disease ( ESRD ) remains impaired despite correction of anemia . Carnitine insufficiency may contribute to impaired exercise and functional capacities in patients with ESRD . Two r and omized placebo-controlled trials were conducted to test whether intravenous L-carnitine improves exercise capacity ( assessed by maximal rate of oxygen consumption [ VO(2max ) ] ) and quality of life ( measured by the Kidney Disease Question naire [ KDQ ] ) in patients with ESRD . In study A , patients were administered L-carnitine , 20 mg/kg ( n = 28 ) , or placebo ( n = 28 ) intravenously at the conclusion of each thrice-weekly dialysis session for 24 weeks . In study B , a dose-ranging study , patients were administered intravenous L-carnitine , 10 mg/kg ( n = 32 ) , 20 mg/kg ( n = 30 ) , or 40 mg/kg ( n = 32 ) , or placebo ( n = 33 ) as in study A. The prospect i ve primary statistical analysis evaluated changes in VO(2max ) in each study and specified that changes in the KDQ were assessed only in the combined population s. L-Carnitine supplementation increased plasma carnitine concentrations , but did not affect VO(2max ) in either study . Because change in VO(2max ) showed significant heterogeneity , a secondary analysis using a mixture of linear models approach on the combined study population s was performed . L-Carnitine therapy ( combined all doses ) was associated with a statistically significant smaller deterioration in VO(2max ) ( -0.88 + /- 0.26 versus -0.05 + /- 0.19 mL/kg/min , placebo versus L-carnitine , respectively ; P = 0.009 ) . L-Carnitine significantly improved the fatigue domain of the KDQ after 12 ( P = 0.01 ) and 24 weeks ( P = 0.03 ) of treatment compared with placebo using the primary analysis but did not significantly affect the total score ( P = 0.10 ) or other domains of the instrument ( P > 0.11 ) . Carnitine was well tolerated , and no drug-related adverse effects were identified . Intravenous L-carnitine treatment increased plasma carnitine concentrations , improved patient-assessed fatigue , and may prevent the decline in peak exercise capacity  in hemodialysis patients .  VO(2max ) in the primary analysis and other assessed end points were unaffected by carnitine therapy
Having this evidence s , the potential role of Carnitine in improving malnutrition consequences in CKD patients would be clearly defined
Protein energy malnutrition is a common problem in patients with chronic kidney disease ( CKD ) .
Scattered reports indicate that supplementation of Carnitine may improve patients ' clinical symptoms , with significant improvement in nutritional parameters .
This systematic review was done to document the evidence s of Carnitine effects in nutritional status of CKD patients .