Effect of L-carnitine supplementation on growth and immunological status of children with chronic renal failure on regular hemodialysis

ABSTRACT

Children with chronic renal failure, including those on hemodialysis are most commonly presented with growth failure and immunological disorders. Deficiency of L-Carnitine, the endogenous intermediate involved in fatty acid metabolism, is commonly encountered in patients with end stage renal disease [ESRD]. This study has been conducted to evaluate the effect of L-Carnitine supplementation on growth and immunological status of children with ESRD. The study was conducted on twenty children with ESRD on regular hemodialysis for 1-6 years. Twelve age and sex matched healthy children were chosen to represent the control group. The growth status was monitored by the routine anthropometric measurements as well as measuring serum levels of insulin-like growth factor-1 [IGF-1]. The immunological status was monitored by measuring serum levels of adenosine deaminase [ADA] enzyme activity as well as serum levels of immunoglobulins G and M [IgG and IgM]. L-Carnitine supplementation was given to all patients in a dose of 50 mg/kg/day orally for 6-months. Basal and post 6-months L-Carnitine supplementation levels of IGF-1, ADA, IgG and IgM were compared to values of healthy controls. L-Carnitine supplementation improves IGF-1 level. Where basal values were significantly lower than those of control while post supplementation values showed insignificant difference when compared to control group. Although ADA activity significantly increased in ESRD patients after L-Carnitine supplementation in comparison to their corresponding basal values, both values were significantly lower when compared to control group. L-Carnitine supplementation had no significant effect on serum levels of IgG and IgM which showed insignificant difference when compared to control group. L-Carnitine supplementation plays an important role in improving both growth and immunological disorders in children with chronic renal failure and it should be considered an intergeral therapy for children on regular hemodialysis