L-Carnitine Supplementation and Adipokines in Patients with End-Stage Renal Disease on Regular Hemodialysis

Abstract Background and Aims According to population registries, the survival of diabetic patients with end-stage-renal disease (ESRD) remains low today. In this context, it is reasonable to develop new therapeutic strategies based on advances in science of the important role of magnesium (Mg) and L-carnitine deficiency (via inflammation and endothelial dysfunction) in mechanisms of cardiovascular remodeling, high morbidity and mortality rates. Thus, the purpose of the present study was to evaluate the effect of Mg and L-carnitine supplementation on 3-year survival and development of the cardiovascular complications in diabetic hemodialysis (HD) patients. Method 48 type 2 diabetic ESRD patients were included in this prospective cohort study (male/female, 29/19; age, 59.9±0.6 years; HD duration, 34.8±4.8 month; diabetes mellitus duration, 174.7±7.1 month). The study was performed in accordance with the provisions of the Declaration of Helsinki last revision. Depending on the treatment programme, patients were divided into two groups: the 1st (main) group (n=24) in addition to basic treatment (hypoglycemic, antihypertensive therapy, according to indications - correction of anemia, hyperparathyroidism, hyperphosphatemia) was treated by combination of magnesium aspartate (0.5 g/day orally) and L-carnitine (1 g/day parenterally after each HD session (three times weekly); the 2nd (comparison) group (n=24) was only on the basic therapy. Complex treatment lasted 12-months; administration of L-carnitine was performed continuously throughout the year, while magnesium aspartate – by three 2-months’ courses/year. The follow up period in both groups was 36 months. Quantitative data are expressed as means±SEM, qualitative ones – as %. Kaplan-Meier method and Log-rank test were used to estimate survival of HD patients, χ2-test – to compare the frequency values. Results The cumulative proportion of survivors at the end of follow-up was 60.4%; however, after 36 months, the survival rate of diabetic HD patients who received a combination of magnesium aspartate and L-carnitine as part of their modified treatment was significantly higher (75 vs. 45.8%; Log-rank=2.07, p=0.038) compared to patients who were on basic therapy (Figure). Survival time in main and comparison groups was 31.9±1.7 and 26.4±2.2 months respectively. It is noteworthy, that throughout the year (from 10 to 22 months), no completed events were recorded in subjects who underwent Mg and L-carnitine supplementation. Conclusion (1) The combined use of magnesium aspartate and L-carnitine in addition to the basic 12-month treatment provides an effective reduction of cardiovascular complications and promotes 3-year survival of diabetic HD patients. (2) The results obtained substantiate the advisability of using repeated courses of Mg and L-carnitine administration 1 years after the end of the primary modified treatment to improve the prognosis in these ESRD patients.

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THE CORRELATION OF ANEMIA AND HEPCIDIN SERUM LEVELS IN REGULAR HEMODIALYSIS PATIENTS WITH CHRONIC HEPATITIS C IN HAJI ADAM MALIK HOSPITAL MEDAN

INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY ◽

10.24293/ijcpml.v25i2.1464 ◽

2019 ◽

Vol 25 (2) ◽

pp. 218

Author(s):

Wingsar Indrawanto ◽

Adi Koesoema Aman ◽

Alwi Thamrin

Keyword(s):

Renal Failure ◽

Chronic Hepatitis ◽

Hepatitis C ◽

Renal Disease ◽

Chronic Hepatitis C ◽

End Stage Renal Disease ◽

Serum Levels ◽

Stage Renal Disease ◽

End Stage ◽

Regular Hemodialysis

Background : End stage renal disease patients who undergo hemodialysis therapy are the high-risk populations who are infected by hepatitis C virus. Some studies have been reported that hepcidin levels decreased in patients with chronic hepatitis C. Hepcidin serum concentrations were also reported to increase in patients with renal failure in the line with increased severity of renal failure, which can cause the accumulation of hepcidin which culminates in anemia because iron deficiency. This Study was to analyze the correlation of anemia and hepcidin serum levels in patients end stage renal disease who undergoing regular hemodialysis with chronic hepatitis C.Methods : This study was an analytic observational with cross sectional design which was conduted on 24 patients end stage renal disease (ESRD) with chronic hepatitis C and 24 patients with ESRD without hepatitis who are undergoing regular hemodialysis theraphy in Haji Adam Malik Hospital, Medan in July – September 2016. All study subjects were examined for full blood count and hepcidin serum levels. The result of the iron status were recorded from the patient’s medical record.Result : In this study, the mean hemoglobin was 8,15±1,44 g/dL, mean hematocrit 25,42±4,53%, median hepcidin levels 29,75 (4,92-359,49) in the patients ESRD with chronic hepatitis C and mean hemoglobin 8,21±1,50 g/dL, mean hematocrit 25,25±4,37%, median hepcidin levels 30,33 (11,65-141,53) in the patients ESRD without hepatitis. In Spearman’s rho test was showed a positive correlation that significant between hepcidin and hemoglobin (r = 0,439, p = 0,032), hepcidin and hematocrit (r = 0,021, p = 0,024) in patients ESRD with chronic hepatitis C.Conclusion : This study showed there was a positive correlation between anemia and hepcidin serum levels in patients ESRD who undergoing regular hemodialysis with chronic hepatitis C.

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Pulmonary hypertension in patients with end-stage renal disease under regular hemodialysis: a cross-sectional study

Egyptian Journal of Chest Diseases and Tuberculosis ◽

10.4103/ejcdt.ejcdt_38_19 ◽

2020 ◽

Vol 69 (1) ◽

pp. 235

Author(s):

MohamedF Abdelghany ◽

WalaaH Mohamad ◽

AhmadB Elden

Keyword(s):

Pulmonary Hypertension ◽

Renal Disease ◽

End Stage Renal Disease ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Stage Renal Disease ◽

End Stage ◽

Regular Hemodialysis

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Neurophysiologic Study in Children with End Stage Renal Disease on Regular Hemodialysis

Al-Azhar International Medical Journal ◽

10.21608/aimj.2021.101072.1607 ◽

2021 ◽

Vol 2 (12) ◽

pp. 28-34

Author(s):

‪mohamed ‬ hasan ◽

Moftah Rabeea ◽

Hassan Hassan ◽

ann Abd-Elkader ◽

Eman Elzamarany

Keyword(s):

Renal Disease ◽

End Stage Renal Disease ◽

Stage Renal Disease ◽

End Stage ◽

Regular Hemodialysis

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The relation between vitamin D status and anemia in patients with end stage renal disease on regular hemodialysis

Journal of Renal Endocrinology ◽

10.34172/jre.2021.15 ◽

2021 ◽

Vol 7 (1) ◽

pp. e15-e15

Author(s):

Essam Nour el Din Afifi ◽

Ahmed Mohamed Tawfik ◽

Essam Eldin Rashed Saeed Abdulkhalek ◽

Lina Essam Khedr

Keyword(s):

Vitamin D ◽

Renal Disease ◽

Serum Calcium ◽

End Stage Renal Disease ◽

Iron Status ◽

Vitamin D Status ◽

Vitamin D Levels ◽

Stage Renal Disease ◽

End Stage ◽

Regular Hemodialysis

Introduction: Anemia is a common complication in end-stage renal disease (ESRD) patients on regular hemodialysis (HD). There has been a lot of interest recently in the non-classical effects of 25(OH) vitamin D (calcidiol), including its association with erythropoiesis and anemia pathogenesis. Objectives: To study the relation between anemia and vitamin D status in patients on regular HD Results: This study is a cross-sectional study that included 90 patients on regular HD. Vitamin D status was classified into deficient (<20 ng/ mL), insufficient (20-30 ng/mL) and sufficient (>30 ng/mL). The level of vitamin D measured in the patients ranged between 3.5 to 66 ng/mL with median of 16.35 ng/mL. There were statistically significant positive correlations between vitamin D levels and the level of hemoglobin (P<0.001), serum calcium levels (P<0.001) and serum PO4 levels (P=0.023). Higher hemoglobin levels were statistically related to both higher vitamin D values (P<0.001) and higher serum calcium concentration P<0.001). Meanwhile, a significant negative correlation was found between hemoglobin levels and serum PTH values (P<0.001). Conclusion: There was a significant association between the status of vitamin D and the level of hemoglobin in dialysis population who were studied, independent from iron status. other associations with hemoglobin levels included PTH level and calcium.

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