Nephroprotective Effects of L-Carnitine against Contrast-Induced Nephropathy in Patients Undergoing Percutaneous Coronary Intervention: A Randomized Open-Labeled Clinical Trial

L-carnitine may prevent the incidence of AKI by its antioxidant effects and improving circulation in ischemic conditions. The goal of this trial was to evaluate the impact of L-carnitine on contrast-induced nephropathy in patients undergoing elective PCI.
Totally, the patients were randomly allocated to 2 groups. The treatment group received 1 g of L-carnitine orally 3 times a day, 24 hours before the procedure (3 g before PCI) and 2 g after PCI, whereas the control group did not receive L-carnitine. In both groups, the plasma level of neutrophil gelatinase-associated lipocalin (NGAL) was measured at baseline and 12 hours after PCI.
Our study was conducted on 202 patients (including 91 vs. 111 patients in the treatment and the control group; 31 (34.1%) vs 33 (29.7%) female in carnitine and control group; and ages include 62.0 ± 9.0 vs 57.0 ± 11.2 years). The median plasma levels of NGAL were not different between the carnitine and control groups at baseline (57 [IQR: 22 – 255] vs. 54 [IQR: 29 – 324]; p value = 0.155) and 12 hours after PCI (71 [IQR: 52 – 129] vs. 70 [IQR: 46 – 153]; p value = 0.925), but the changes in the plasma NGAL from baseline to 12 hours after PCI were different between the 2 groups (5 [IQR:-147 – 30] vs. 17 [IQR: -21 – 41]; p value = 0.010).
Our results showed that oral L-carnitine was able to prevent an increase in NGAL following contrast medium administration in patients undergoing PCI. More studies should be performed to fully elucidate the nephroprotective effects of L-carnitine.