Clinical research on improvement of L-carnitine for malnutrition and cardiac function in uraemia patients with hematodialysis

Objective To evaluate the effect of L-carnitine on improving the malnutrition and cardiac function in uremia with hematodialysis. Methods Seventy four cases in Navy General Hospital of PLA from December 2012 to December 2013 were randomly divided into treatment(37 cases) and control(37 cases) groups. The patients in each group were given a conventional hematodialysis therapy, while the patients in the treatment group were iv given 1g L-carnitine injection after the end of each dialysis for 3 months. The levels of total protein(TP), albumin(Alb), transferrin(TRF), and prealbumin(PA) as well as the cardiac function were observed before and after the treatment. Results After the treatment, the levels of TP, Alb, TRF, and PA were increased and there was a significant difference among them before and after the treatment(P0.05). The total cholesterol was significantly lower in the treatment group than that before treatment and there was a significant difference before and after the treatment(P0.05), which was significantly lower than that after the treatment in the control group(P0.05). After the treatment, the TP, Alb, TRF, and PA in the treatment group were significantly higher than those in the control group(P0.05). After the treatment, the left ventricular diameter(LAD), left ventricular posterior wall thickness(LVPWT), and the inter-ventricular septum thickness(IVST) were significantly reduced in the two groups than those before the treatment(P0.05). There was a significant difference before and after the treatment in the same group(P0.05), and comparing to that before the treatment, the left ventricular end systolic diameter(LVDs) and left ventricular end diastolic diameter(LVDd) in the treatment group were obviously improved with a significant difference(P0.05). After the treatment, the levels of LAD, LVDs, LVDd, and LVPWT in the treatment group were lower than those in the control group with a significant difference(P0.05). After the treatment, the E/A value and the left ventricular ejection fraction(EF) were more significantly increased than those before the treatment in the two groups(P0.05), and the calculated left atrial stroke volume(SV) after the treatment was obviously decreased than that before the treatment in the treatment group with a significant difference(P0.05). After the treatment, the E/A and EF values in the treatment group were significantly higher than those in the control group, while the SV value was significantly lower than that in the control group. There was a significant difference between the two groups(P0.05). Conclusion Iv injection of L-carnitine could significantly improve the situation of malnutrition in hemodialysis patients, protect the myocardial cells and delay the further damage of the cardiac structure and function, which is worthy of clinical application.