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Abstract: TH-PO258

L-Carnitine Supplementation Enhances Physical Activity and Improves Muscle Quality in Hemodialysis Patients

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Yano, Junko, Kurume University School of Medicine,Division of Nephrology, Kurume, Japan
  • Ito, Sakuya, Kurume University School of Medicine,Division of Nephrology, Kurume, Japan
  • Kaida, Yusuke, Kurume university, Kurume, Japan
  • Nakayama, Yosuke, Kurume University School of Medicine,Division of Nephrology, Kurume, Japan
  • Kodama, Goh, Kurume University School of Medicine,Division of Nephrology, Kurume, Japan
  • Fukami, Kei, Kurume University School of Medicine,Division of Nephrology, Kurume, Japan
Background

Carnitine plays a central role in the activation of fatty acid b-oxidation and energy production by transporting long-chain fatty acids from the cytoplasm to mitochondria. We previously reported that serum carnitine levels are significantly decreased in hemodialysis (HD) patients and thereby involved in muscle atrophy and decreased quality of life. Moreover, recent evidence has suggested that ergometer exercise can be effective against sarcopenia and frailty in HD patients. However, whether L-carnitine supplementation or ergometer exercise can improve HD-related impairment of physiological activity and muscle quality is yet to be elucidated. Here we prospectively examined this issue.

Methods

Twenty patients undergoing HD were divided into two groups: L-carnitine group (n = 10) and exercise group (n = 10). Patients were treated with L-carnitine supplementation (1000 mg intravenously) for 3 months. Muscle and fat mass were measured using impedance methods. Physical activity was evaluated using indices, including grip strength, lower limb extension strength, chair stand up time, 10 m walking times (10 mWT), functional reach test, time up & go test, and the Borg Scale. We further evaluated muscle mass quality using magnetic resonance imaging.

Results

Total and free carnitine levels in the serum significantly decreased in HD patients than in healthy subjects (both p < 0.001). At baseline, muscle mass and the Borg scale were positively associated with free carnitine levels; however, the other variables were not. L-carnitine supplementation significantly increased muscle mass (p = 0.023) and thigh circumstance (p = 0.019), decreased fat mass (p = 0.007), and improved chair stand up time (p = 0.003) and 10 mWT (p = 0.004). Ergometer exercise did not improve any physical activity. Notably, the intramuscular fat fraction significantly decreased with L-carnitine supplementation (p = 0.023), suggesting the improvement of muscle quality.

Conclusion

Compared with ergometer exercise, L-carnitine supplementation had superior effects on physical activity and muscle quality in HD patients. These observations suggest that L-carnitine supplementation may be a novel therapeutic strategy for HD-related sarcopenia and frailty.