SynthesisPloS one2022
The effect of levocarnitine supplementation on dialysis-related hypotension: A systematic review, meta-analysis, and trial sequential analysis.
Synthesis in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it, 17 citations in OpenAlex.
- The effects of L-carnitine in children with kidney failure undergoing dialysis: a systematic review.Pediatric nephrology (Berlin, Germany) · 2026Pooled it
- Management of blood pressure in adults, children and young people on dialysis: UK kidney association clinical practice guideline.BMC nephrology · 2025Guideline
- A Narrative Summary of Strategies to Mitigate Intradialytic Hypotension in Poisoned Patients Requiring Extracorporeal Toxin Elimination.Journal of medical toxicology : official journal of the American College of Medical Toxicology · 2026Review
- Nutritional Challenges in Hemodialysis: A Perspective from Albania.The Eurasian journal of medicine · 2026Article
- Carnitine Deficiency in Chronic Kidney Disease: Pathophysiology, Clinical Implications, and Therapeutic Perspectives.Nutrients · 2025Review
- Treatment of insomnia, restless legs, cramps, and pain associated with chronic kidney disease: results from a multinational survey of kidney supportive care practice.BMC nephrology · 2025Article
- Knowledge and Practice of Nurses on Prevention and Management of Intradialytic Hypotension at Kiruddu and Mulago National Referral Hospitals.International journal of nephrology and renovascular disease · 2025Article
- The Effect of Muscle Cramps During Hemodialysis on Quality of Life and Habitual Physical Activity.Medicina (Kaunas, Lithuania) · 2024Article
- Revisiting the Role of Carnitine in Heart Disease Through the Lens of the Gut Microbiota.Nutrients · 2024Review
- Imatinib therapy of chronic myeloid leukemia significantly reduces carnitine cell intake, resulting in adverse events.Molecular metabolism · 2024Article
- Prediction models for intradialytic hypotension in hemodialysis patients: A protocol for systematic review and critical appraisal.PloS one · 2024Article
- Outcomes and complications of hemodialysis in patients with renal cancer following bilateral nephrectomy.Open medicine (Warsaw, Poland) · 2024Article
- Muscle Cramps in Outpatients with Liver Diseases in Tokyo, Japan.Medicina (Kaunas, Lithuania) · 2023Article
- Prevention of Intradialytic Hypotension in Hemodialysis Patients: Current Challenges and Future Prospects.International journal of nephrology and renovascular disease · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundDialysis patients have been shown to have low serum carnitine due to poor nutrition, deprivation of endogenous synthesis from kidneys, and removal by hemodialysis. Carnitine deficiency leads to impaired cardiac function and dialysis-related hypotension which are associated with increased mortality. Supplementing with levocarnitine among hemodialysis patients may diminish incidence of intradialytic hypotension. Data on this topic, however, lacks consensus.
methodsWe conducted electronic searches in PubMed, Embase and Cochrane Central Register of Controlled Trials from January 1960 to 19th November 2021 to identify randomized controlled studies (RCTs), which examined the effects of oral or intravenous levocarnitine (L-carnitine) on dialysis-related hypotension among hemodialysis patients. The secondary outcome was muscle cramps. Study results were pooled and analyzed utilizing the random-effects model. Trial sequential analysis (TSA) was performed to assess the strength of current evidence.
resultsEight trials with 224 participants were included in our meta-analysis. Compared to control group, L-carnitine reduced the incidence of dialysis-related hypotension among hemodialysis patients (pooled OR = 0.26, 95% CI [0.10-0.72], p = 0.01, I2 = 76.0%). TSA demonstrated that the evidence was sufficient to conclude the finding. Five studies with 147 participants showed a reduction in the incidence of muscle cramps with L-carnitine group (pooled OR = 0.22, 95% CI [0.06-0.81], p = 0.02, I2 = 74.7%). However, TSA suggested that further high-quality studies were required. Subgroup analysis on the route of supplementation revealed that only oral but not intravenous L-carnitine significantly reduced dialysis-related hypotension. Regarding dose and duration of L-carnitine supplementation, the dose > 4,200 mg/week and duration of at least 12 weeks appeared to prevent dialysis-related hypotension.
conclusionSupplementing oral L-carnitine for at least three months above 4,200 mg/week helps prevent dialysis-related hypotension. L-carnitine supplementation may ameliorate muscle cramps. Further well-powered studies are required to conclude this benefit.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.