Long-term L-Carnitine Administration reduces Erythropoietin Resistance in Chronic Hemodialysis Patients with Thalassemia Minor

  • Biagio R. Di Iorio Unità Operativa di Nefrologia e Dialisi, Ospedale “A Landolfi”, Solofra (AV), Italy.
  • Pasquale Guastaferro Unità Operativa di Nefrologia e Dialisi, Ospedale, San Angelo dei Lombardi (AV), Italy.
  • Nicola Cillo Unità Operativa di Nefrologia e Dialisi, Ospedale “A Landolfi”, Solofra (AV), Italy.
  • Emanuele Cucciniello Unità Operativa di Nefrologia e Dialisi, Ospedale “A Landolfi”, Solofra (AV), Italy.
  • Vincenzo Bellizzi Unità Operativa di Nefrologia e Dialisi, Ospedale “A Landolfi”, Solofra (AV), Italy.
Keywords: L-carnitine, Thalassemia minor, Hemodialysis

Abstract

Background and Aim: Both thalassemia and carnitine deficiency represent independent causes of erythropoietin resistance, and thus anemia, in uremic patients. We evaluated the unknown long-term effects of L-carnitine administration in β-thalassemic on chronic hemodialysis. Methods: We studied twelve subjects (M = 8; F = 4) affected by β-thalassemia minor (β-thal; HbA2 level = 6.6 ± 0.6%) and forty non-thalassemic subjects (M = 24; F = 16) as controls (C), on chronic hemodialysis treatment. Patients and controls were at target hemoglobin levels (11–12g/dl) prior to the study and underwent to i.v. L-carnitine administration for a one year period-time. Results: Groups were comparable for age, gender, serum levels of hemoglobin (Hb), iron, ferritine, PTH and aluminum, transferrin saturation, and dialysis modalities. During the study both groups showed significant Hb increase and erythropoietin (EPO) decrease; as a difference, such changes emerged at the 3rd month in C but at the 8th month in β-thal. At start, during the dialysis session the erythrocyte MCV reduced in C but not in β-thal (65.3 ± 3.2 to 65.5 ± 3.2 fl; NS); along carnitine administration period, however, MCV during dialysis decreased also in β-thal, starting since the 9th month of treatment. Conclusion: This study provides evidence of the lowering of EPO resistance in β-thalassemia patients on hemodialysis due to long-term carnitine administration. Thus, prolonged carnitine supplementation should be suggested to patients on dialysis affected by β-thalassemia with poorly responsive anemia, or requiring large doses of erythropoietin.
Published
2007-01-01
How to Cite
Di IorioB. R., GuastaferroP., CilloN., CuccinielloE., & BellizziV. (2007). Long-term L-Carnitine Administration reduces Erythropoietin Resistance in Chronic Hemodialysis Patients with Thalassemia Minor. Drug Target Insights, 2(1). https://doi.org/10.33393/dti.2007.1299
Section
Original Research Article