nephroprotective effects of l-carnitine against contrast-induced nephropathy in patients undergoing percutaneous coronary intervention: a randomized open-labeled clinical trial

background: 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. methods: 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. results: 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). conclusion: 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.