A Meta-analysis of the treatment of uremic peripheral neuropathy with levocarnitine combined with hemodialysis

Objective To evaluate the clinical efficacy of levocarnitine combined with hemodialysis versus hemodialysis alone in the treatment of uremic peripheral neuropathy. Methods The randomized clinical trials (RCTs) of levocarnitine combined with hemodialysis versus hemodialysis in uremic peripheral neuropathy were searched from CNKI, WanFang Date, WeiPu Date, CBM, PUBMED, EMBASE, Cochrane Library, from the inception to November 18, 2017. Meanwhile, the corresponding Chinese literature was also retrieved manually. Meta-analysis was performed using RevMan 5.3 software offered by Cochrane Library. Results After strict selection by the evaluator, our review included 9 RCTs involving 756 patients in Chinese. Meta-analysis demonstrated that the efficacy of levocarnitine combined with hemodialysis in the treatment of uremic peripheral neuropathy was significantly higher than hemodialysis alone (RR=2.13, 95%CI 1.69-2.69, P<0.01), besides the sensory conduction velocity (SCV) was also significantly improved (RR=6.92, 95%CI 5.77-8.08, P<0.01). Conclusions Levocarnitine combined with hemodialysis is more effective than hemodialysis alone for the therapy of uremic peripheral neuropathy in Chinese patients with simple method and the maneuverability is strong, but further large scale RCTs with high quality are needed to confirm these results.