l‐carnitine supplementation vs cycle ergometer exercise for physical activity and muscle status in hemodialysis patients: A randomized clinical trial

Serum carnitine is decreased in hemodialysis patients, which induces muscle atrophy. Thus, we examined the different effects of l‐carnitine and exercise on exercise activity and muscle status in hemodialysis patients. Twenty patients were divided into l‐carnitine and cycle ergometer groups and were followed for 3 months. Muscle and fat mass, physical activities, and muscle status were evaluated by an impedance, physical function test, and magnetic resonance imaging, respectively. The l‐carnitine significantly increased muscle mass (P = .023) and thigh circumference (P = .027), decreased fat mass (P = .007), and shortened chair stand‐up time (P = .002) and 10‐m walk test (P = .037). The fat fraction was improved by the l‐carnitine (P = .047). Compared with the exercise group, l‐carnitine improved the changes in 10‐m walk test (P = .026), chair stand‐up time (P = .014), and thigh circumference (P = .022). Baseline fibroblast growth factor‐21 and myostatin levels predicted the l‐carnitine‐associated changes in exercise activities. l‐carnitine, rather than exercise, improved physical activity and muscle status in hemodialysis patients.