Renal protective effect of levocarnitine on patients with diabetic kidney disease underwent maintenance hemodialysis
Objective To analyze the renal protective effect of levocarnitine on patients with diabetic kidney disease(DKD)underwent maintenance hemodialysis(MHD)based on transforming growth factorβ1(TGF-β1)/drosophila mothers against decapentaplegic(Smad)pathway.Methods The clinical data of patients with DKD underwent MHD were retrospectively analyzed,and were divided into treatment group and control group.Control received conventional symptomatic treatment such as anticoagulation with low molecular weight heparin;treatment group received levocarnitine on the basis of conventional symptomatic treatment.The renal function[serum creatinine(Scr),β2-microglobulin(β2-MG),blood urea nitrogen(BUN)],inflammatory status[C-reactive protein(CRP),interleukin-17(IL-17),interleukin-6(IL-6)],lipid metabolism[lipoprotein a(Lp-a),high-density lipoprotein cholesterol(HDL-C),triglyceride(TG)]and TGF-β1/Smad pathway(TGF-β1,Smad4,Smad7)were observed in the two groups of patients with DKD before treatment and after 3 months of treatment,and the adverse drug reactions during treatment were recorded.Results There were 38 cases in control group,and 44 cases in treatment group.After 3 months of treatment,the Scr levels in treatment group and control group were(198.26±18.33)and(254.19±21.08)μmol·L-1,the β2-MG levels were(15.22±3.09)and(21.69±4.20)mg·L-1,BUN levels were(15.32±3.11)and(19.67±3.79)mmol·L-1,CRP levels were(6.48±1.27)and(7.44±1.39)mg·L-1,IL-17 levels were(8.78±1.45)and(10.23±1.98)pg·mL-1,IL-6 levels were(43.28±7.01)and(50.32±8.24)pg·mriL-1,Lp-a levels were(220.71±28.37)and(249.63±32.40)mg·L-1,TG levels were(1.52±0.31)and(1.72±0.34)mmol·L-1,HDL-C levels were(1.20±0.16)and(1.12±0.14)mmol·L-1,all with significant difference(all P＜0.05).After 3 months of treatment,the relative expression levels of TGF-β1,Smad4 and Smad7 in treatment group were 1.45±0.31,1.55±0.33 and 2.03±0.41,and those in control group were 1.80±0.33,1.86±0.35 and 1.55±0.33 respectively(all P＜0.05).The incidence rates of adverse reactions in and treatment group control group during treatment were 2.27％and 0 respectively(P＞0.05).Conclusion Levocarnitine can reduce inflammation level,improve lipid metabolism,regulate TGF-β1/Smad pathway,and protect renal function in MHD treatment of patients with DKD.
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