L-Carnitine & Anemia

In addition to filtering the blood and removing waste products, the kidneys also regulate blood pressure, keep potassium and phosphorus levels in a healthy range and aid in the maturation of red blood cells. Given the many functions of the kidneys, it is little surprise that patients with advanced disease also have problems with anemia and low levels of L-carnitine.

L-Carnitine

L-carnitine, also referred to as "carnitine," is an amino acid made by the body. The "L" stands for levorotary, indicating that this is a left-handed optical isomer, as are most biologically active molecules. Because you are not dependent on dietary sources of carnitine, deficiencies do not occur in healthy people. A study reported in the August 1989 "American Journal of Clinical Nutrition" showed that even vegetarians have adequate carnitine levels.

Anemia

Anemia is a general name for a red blood cell count. Immature red blood cells called reticulocytes form in the bone marrow. The kidneys make a hormone called erythropoitin, or EPO. Exposure to EPO causes reticulocytes to mature into adult red blood cells with hemoglobin.

The Linus Pauling Institute reports that lack of dietary iron is the most common cause of anemia. Other possible causes include viruses attacking the red blood cells, genetic defects such as sickle cell anemia, absorption problems and bone marrow disease.

Kidney Disease

Low carnitine levels and anemia are seen together in patients with advanced kidney disease who are on dialysis. Dialysis is a lifesaving treatment applied when the kidneys no longer can sustain life. In addition to removing waste products, dialysis also removes needed carnitine. Dialysis patients also suffer from renal anemia because their kidneys are too impaired to make EPO. Such patients often present with high reticulocyte counts and low red blood cell counts.

Carnitine Treatment

Even though it is well established that dialysis patients tend to have very low levels of carnitine, the National Kidney Foundation reports that there is insufficient evidence that L-carnitine supplementation has any benefit. It urges more clinical trials to examine the effect of carnitine supplementation on anemia, cardiomyopathy and inflammation. In the meantime, however, it recommends high-protein diets for dialysis patients to prevent muscle wasting.

Renal Anemia Treatment

Nephrologists are more aggressive in treating renal anemia because this makes a significant difference in a patient's quality of life. Patients learn how to give themselves injections of synthetic EPO. The synthetic EPO works just like the EPO their kidneys used to make. Patients become less fatigued and breathless approximately two weeks after starting treatment because it takes this long for reticulocytes to mature into red blood cells.