| Theme |
Erythropoietin Up-To-Date |
| Title |
L-carnitine and renal anemia |
| Author |
Ichiro Koni |
Molecular Genetic of Cardiovascular Disorders, Graduate School of Medical Science, Kanazawa University |
| Author |
Masami Matsumura |
Ishikawa Prefectural Hospital |
| [ Summary ] |
Recombinant human erythropoietin (rHuEPO) therapy corrects renal anemia and considerably helps to improve the quality of life in dialysis patients. However, there are some patients with poor responses to rHuEPO, due to erythropoietin resistance, carnitine deficiency also being one of the causes. Carnitine plays an important role in heart and skeletal muscle energy metabolism as a carrier of long-chain fatty acids into the mitochondria. In patients undergoing dialysis, serum carnitine levels are often reduced and there is a relation ship between carnitine deficiency and muscle weakness. L-carnitine supplementation helps prevent erythrocyte osmotic fragility and also increases erythrocyte survival time, which may make it possible to reduce doseage of rHuEPO to maintain target hematocrit. Because carnitine corrects renal anemia by a different mechanism than rHuEPO, we should try its concomitant supplementation in poor responders to rHuEPO. |