Determination of Intravenous L- Carnitine in HD Patients and Some of Its Benefits

L-carnitine is an essential cofactor in fatty acid and energy metabolism and has become of interest in end-stage renal disease and dialysis patients. Chronic kidney disease (CKD) patients could be predisposed to carnitine deficiency due too many factors, however, serum carnitine concentrations tend to decrease more at longer dialysis duration. L-Carnitine has been used as adjuvant therapy in HD for many years L- Carnitine has been used inconsistently with an argument in many HD Units and was generally free of serious side effects. Therefore, we recorded the effect of intravenous L- Carnitine in HD patients complaining of muscle fatigue and weakness. This is a clinical and laboratory observation at Arar general hospital in Kingdom Saudi Arabia (KSA) and included eleven patients on maintenance HD. The observation was performed for more than 30 months starting from November 2017 until Feb 2020. All patients had been complaining of muscle fatigue and weakness manifestations. The patients started to receive management in the form of intravenous injection of L-carnitine ampoule (1000 mg) post HD session three times/week for eighteen months up to two years. At the start of the year 2020, Because of the inaccessibility of the L-carnitine, all patients discontinue its usage compulsory. The eleven patients involved in the observation received L-carnitine ampoule each HD session and all of them had improved as regards their complaints of muscle fatigue and weakness either totally or partly. After discontinuation of the drug; the patients started to complain once more from muscle fatigue and weakness as before the start of management except for one patient who worsened furthermore. Four of the observed patients were complaining of intradialytic hypotension which disappeared with the use of L- carnitine ampoule and reappeared again after the stop of L- carnitine.

Conclusion: The intravenous L-carnitine ampoule of 1000 mg post HD three times/week could be valuable in HD patients with special manifestations comprising intra-dialytic hypotension and muscle weakness or fatigue.