Safety and efficacy of L-carnitine supplementation in improving cardiac function of hemodialysis patients: a systematic review and meta-analysis

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#humans #carnitine #renal-dialysis #dietary-supplements #ventricular-function-left

Safety and efficacy of L-carnitine supplementation in improving cardiac function of hemodialysis patients: a systematic review and meta-analysis

Nabi et al., 2025 | Int Urol Nephrol | Meta Analysis

Citation

Nabi Rayyan, Farooqi Hanzala Ahmed, ... Nabi Zahid. Safety and efficacy of L-carnitine supplementation in improving cardiac function of hemodialysis patients: a systematic review and meta-analysis. Int Urol Nephrol. 2025-Sep;57(9):2935-2951. doi:10.1007/s11255-025-04478-2

Abstract

PURPOSE: Heart failure is a significant complication among patients undergoing hemodialysis, often associated with left ventricular hypertrophy and dysfunction. L-carnitine, crucial for fatty acid metabolism, has shown promise in improving cardiac function. This systematic review and meta-analysis aim to evaluate the safety and efficacy of L-carnitine supplementation in improving cardiac function in hemodialysis patients. METHODOLOGY: A comprehensive search of PubMed, Cochrane, and EMBASE was conducted up to October 3, 2024, to identify relevant studies. The trials assessing the effects of L-carnitine on echocardiographic parameters such as left ventricular ejection fraction (LVEF), left ventricular mass index (LVMI), and diastolic function were included. A random-effects model was applied to pool data, and heterogeneity was assessed using the I2 statistic. RESULTS: A total of 23 studies were included in the systematic review, with 7 studies involving 426 participants being meta-analyzed. L-carnitine supplementation significantly improved LVEF (MD = 1.64, 95% CI 0.10-3.17, p = 0.04), with low heterogeneity (I2 = 37%). However, no significant changes were observed for LVMI (MD = -3.19, p = 0.60) or diastolic markers (E/A ratio MD = -0.13, p = 0.47; E/e ratio MD = -0.35, p = 0.67). CONCLUSION: L-carnitine supplementation significantly improves cardiac function, particularly systolic function (LVEF) in hemodialysis patients. However, its effects on LVMI and markers of diastolic function are inconclusive. Future large-scale trials are warranted to further elucidate its role in cardiac function among this population.

Key Findings

A total of 23 studies were included in the systematic review, with 7 studies involving 426 participants being meta-analyzed. L-carnitine supplementation significantly improved LVEF (MD = 1.64, 95% CI 0.10-3.17, p = 0.04), with low heterogeneity (I2 = 37%). However, no significant changes were observed for LVMI (MD = -3.19, p = 0.60) or diastolic markers (E/A ratio MD = -0.13, p = 0.47; E/e ratio MD = -0.35, p = 0.67).

Outcomes Measured

  • systolic blood pressure
  • diastolic blood pressure

Population

Field Value
Population See abstract
Sample Size 426
Age Range See abstract
Condition See abstract

MeSH Terms

  • Humans
  • Carnitine
  • Renal Dialysis
  • Dietary Supplements
  • Ventricular Function, Left
  • Heart Failure
  • Treatment Outcome

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Systematic Review, Meta-Analysis
  • Vertical: carnitine-cardiovascular

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09