Efficacy of levocarnitine for renal anemia in hemodialysis patients

Abstract

【Objectives】To evaluate the efficacy of levocarnitine for renal anemia in hemodialysis patients. 【Subjects】Among the 192 patients with maintenance dialysis at our hospital, we conducted a questionnaire survey on the desire for treatment with levocarnitine in 153 of them. Of these patients, 113 wanted to take the drug (Treated group) and 40 did not (Control group). 【Methods】This clinical research involved a non-randomized controlled trial. The Treated group received levocarnitine at 20 mg/kg (maximum dose : 1,200 mg/day). As erythropoiesis-stimulating agents (ESAs), the dose conversion from recombinant human erythropoietin to darbepoetin α was predicted as 200 : 1. Response to ESA therapy was determined by calculation of erythropoiesis resistance index (ERI) using the following parameters : 1) weekly ESA doses and 2) weekly ESA doses/kg/g/dL. 【Results】1) The target levels of Hb and hematocrit were reached during the period from study initiation up to month 6 in both Treated and Control groups. 2) The quantity of ESAs used tended to decrease gradually in the Treated group, showing a significant difference at month 6. Furthermore, the Treated group had a significantly smaller quantity at month 6 compared with the Control group. 3) weekly ESA doses/kg/g/dL showed a significant decrease at month 6 in the Treated group, with a significant difference between the two groups at months 3 and 6. 【Conclusions】The results suggest that levocarnitine can reduce the quantity of ESAs in renal anemia in patients on hemodialysis and improve the response to therapy with ESAs.