血透患者卡尼汀治疗与住院风险降低有关 Carnitine Therapy is associated with decreased hospital utilization among HD pati

Abstract

Background/Aims: Hospitalizations account for 41%of the total cost of end-stage renal disease (ESRD） care.Carnitine deficiency is common among dialysis pa-tients, and some studies have shown improvements inanemia, and cardiac and skeletal muscle function uponadministration of L-carnitine. We hypothesized that L-carnitine may 6e associated with decreased hospital utilization in these patients. Methods: The Fresenius Medical Care North America dialysis database was used forthis retrospective analysis. Adult patients who received carnitine for at least 3months, and had at feast 3 months of pre-carnitine follow-up were included in the study. Hospitalization and hospital day rates were compared before and during carnitine therapy, and with a matched population. Results: Carnitine therapy at a mean dose of i.5±0.7 g per administration for an averageof 9.7土5.4 months was associated with a sig-nificant reduction in hospital utilization. Patients with

cardiovascular disease, defined as hospitalizations for angina, rrtyocardial infarction, arrhythmia, congestive heart failure, cerebral vascular disease or peripheral vascular disease prior to receiving carnitine, and those with anemia and hypoalbuminemia derived the great- est benefit from carnitine therapy. In a multivariate analysis, compared to 3 rrioi}ths prior to the initiation ofcarnitine,fheadjusted relative riskfor hospitalization was 11，11，and 15% lower at 3, 6, and 9 months, respec-tively. Among patients with cardiovascular disease, the reduction in risk was even more significant (24, 31，and 34% lower at 3, 6, and 9 months, respectivelyJ. Similar results were observed with adjusted relative risk for hospital days. Conclusion: Administration of L-carni-tine to.chronic hemodialysis patients is associated with lower hospital utilization.

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