scholarly journals Effects of l-Carnitine Supplementation in Patients Receiving Hemodialysis or Peritoneal Dialysis

Nutrients ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3371 ◽  
Author(s):  
Masako Kuwasawa-Iwasaki ◽  
Hiroaki Io ◽  
Masahiro Muto ◽  
Saki Ichikawa ◽  
Keiichi Wakabayashi ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Cardiac Function ◽  
Acid Metabolism ◽  
Carnitine Deficiency ◽  
Muscle Spasm ◽  
Free Carnitine ◽  
Carnitine Supplementation ◽  
Dialysis Patients ◽  
Muscle Spasms ◽  
Total Carnitine

l-carnitine is an important factor in fatty acid metabolism, and carnitine deficiency is common in dialysis patients. This study evaluated whether l-carnitine supplementation improved muscle spasm, cardiac function, and renal anemia in dialysis patients. Eighty Japanese outpatients (62 hemodialysis (HD) patients and 18 peritoneal dialysis (PD) patients) received oral l-carnitine (600 mg/day) for 12 months; the HD patients further received intravenous l-carnitine injections (1000 mg three times/week) for 12 months, amounting to 24 months of treatment. Muscle spasm incidence was assessed using a questionnaire, and cardiac function was assessed using echocardiography. Baseline free carnitine concentrations were relatively low in patients who underwent dialysis for >4 years. Total carnitine serum concentration, free carnitine, and acylcarnitine significantly increased after oral l-carnitine treatment for 12 months, and after intravenous l-carnitine injection. There was no significant improvement in muscle spasms, although decreased muscle cramping after l-carnitine treatment was reported by 31% of patients who had undergone HD for >4 years. Hemoglobin concentrations increased significantly at 12 and 24 months in the HD group. Therefore, l-carnitine may be effective for reducing muscle cramping and improving hemoglobin levels in dialysis patients, especially those who have been undergoing dialysis for >4 years.

Association of Carnitine Deficiency in Indian Continuous Ambulatory Peritoneal Dialysis Patients with Anemia, Erythropoietin Use, Residual Renal Function, and Diabetes Mellitus

2007 ◽  
Vol 27 (2_suppl) ◽  
pp. 235-238
Author(s):  
S. Ramalakshmi ◽  
Bjoe Baben ◽  
Ben S. Ashok ◽  
V. Jayanthi ◽  
Nancy Leslie ◽  
...  
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Residual Renal Function ◽  
Carnitine Deficiency ◽  
Free Carnitine ◽  
Dialysis Patients ◽  
Carnitine Level ◽  
Daily Urine ◽  
The Mean ◽  
Daily Urine Output

♦ In the present study, we aimed to determine levels of free carnitine in hemodialysis (HD) and peritoneal dialysis (PD) patients in India and to correlate carnitine deficiency with various clinical parameters. ♦ Patients on HD and PD at two tertiary care centers were selected for the study. Baseline data were obtained, and a free carnitine analysis was performed. Carnitine deficiency was defined as a free carnitine level of less than 40 μmol/L. ♦ The total number of study patients was 96 (77 on HD, 19 on PD). In the PD group, the mean age was 56 years, with 26.3% of the patients being vegan, 47.4% having diabetes, and 57.9% having a daily urine output of <500 mL. The mean carnitine level in that group was 38.9 μmol/L, and 68.4% of the patients had a carnitine deficiency. A Pearson correlation test failed to show any association of carnitine level with parameters such as anemia, use of erythropoietin, non-vegetarian diet, diabetes, and hypertension. In the HD group, the mean age was 45 years, with 22% of the patients being vegan, 23% having diabetes, and 45.5% having a daily urine output of <500 mL. The mean carnitine level in the group was 38.2 μmol/L, and 64.3% of the patients had a carnitine deficiency. Residual renal function and duration of dialysis were different in HD patients with and without carnitine deficiency. Carnitine levels in the HD group correlated positively and statistically significantly with the presence of diabetes and hypertension. ♦ Conclusion This study is the first demonstration that Indian dialysis patients have carnitine deficiency.

Carnitine supplementation improves apolipoprotein B levels in pediatric peritoneal dialysis patients

2003 ◽  
Vol 18 (11) ◽  
pp. 1184-1188 ◽  
Author(s):  
Celalettin Kosan ◽  
Lale Sever ◽  
Nil Arisoy ◽  
Salim �aliskan ◽  
�zg�r Kasap�opur
Keyword(s):  
Peritoneal Dialysis ◽  
Apolipoprotein B ◽  
Carnitine Supplementation ◽  
Dialysis Patients

scholarly journals Carnitine Deficiency and Oxidative Stress Provoke Cardiotoxicity in an Ifosfamide-Induced Fanconi Syndrome Rat Model

2010 ◽  
Vol 3 (4) ◽  
pp. 266-274 ◽  
Author(s):  
Mohamed M. Sayed-Ahmed ◽  
Amal Q. Darweesh ◽  
Amal J. Fatani
Keyword(s):  
Oxidative Stress ◽  
Serum Creatinine ◽  
Normal Saline ◽  
Fanconi Syndrome ◽  
Carnitine Deficiency ◽  
Carnitine Supplementation ◽  
Acetyl Coa ◽  
Cardiac Tissues ◽  
Total Carnitine ◽  
And Oxidative Stress

In addition to hemorrhagic cystitis, Fanconi Syndrome is a serious clinical side effect during ifosfamide (IFO) therapy. Fanconi syndrome is a generalized dysfunction of the proximal tubule which is characterized by excessive urinary excretion of glucose, phosphate, bicarbonate, amino acids and other solutes excreted by this segment of the nephron including L-carnitine. Carnitine is essential cofactor for β-oxidation of long-chain fatty acids in the myocardium. IFO therapy is associated with increased urinary carnitine excretion with subsequent secondary deficiency of the molecule. Cardiac abnormalities in IFO-treated cancer patients were reported as isolated clinical cases. This study examined whether carnitine deficiency and oxidative stress, secondary to Fanconi Syndrome, provoke IFO-induced cardiomyopathy as well as exploring if carnitine supplementation using Propionyl-L-carnitine (PLC) could offer protection against this toxicity. In the current study, an animal model of carnitine deficiency was developed in rats by D-carnitine-mildronate treatment Adult male Wistar albino rats were assigned to one of six treatment groups: the first three groups were injected intraperitoneally with normal saline, D-carnitine (DC, 250 mg/kg/day) combined with mildronate (MD, 200 mg/kg/day) and PLC (250 mg/kg/day), respectively, for 10 successive days. The 4th, 5thand 6thgroups were injected with the same doses of normal saline, DC-MD and PLC, respectively for 5 successive days before and 5 days concomitant with IFO (50 mg/kg/day). IFO significantly increased serum creatinine, blood urea nitrogen (BUN), urinary carnitine excretion and clearance, creatine phosphokinase isoenzyme (CK-MB), lactate dehydrogenase (LDH), intramitochondrial acetyl-CoA/CoA-SH and thiobarbituric acid reactive substances (TBARS) in cardiac tissues and significantly decreased adenosine triphosphate (ATP) and total carnitine and reduced glutathione (GSH) content in cardiac tissues. In carnitine-depleted rats, IFO induced dramatic increase in serum creatinine, BUN, CK-MB, LDH, carnitine clearance and intramitochondrial acetyl-CoA/CoA-SH, as well as progressive reduction in total carnitine and ATP in cardiac tissues. Interestingly, PLC supplementation completely reversed the biochemical changes-induced by IFO to the control values. In conclusion, data from the present study suggest that: Carnitine deficiency and oxidative stress, secondary to Fanconi Syndrome, constitute risk factors and should be viewed as mechanisms during development of IFO-induced cardiotoxicity. Carnitine supplementation, using PLC, prevents the development of IFO-induced cardiotoxicity through antioxidant signalling and improving mitochondrial function.

scholarly journals Chronic effects of arteriovenous fistula occlusion on cardiac function in continuous ambulatory peritoneal dialysis patients.

1994 ◽  
Vol 27 (10) ◽  
pp. 1331-1335
Author(s):  
Shigetaka Takamizawa ◽  
Makoto Ohta ◽  
Shigeaki Satoh ◽  
Masanori Utsunomiya ◽  
Masuteru Ono ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Cardiac Function ◽  
Arteriovenous Fistula ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Dialysis Patients ◽  
Chronic Effects

Impact of Volume Management on Volume Overload and Rehospitalization in CAPD Patients

2016 ◽  
Vol 40 (5) ◽  
pp. 725-737 ◽  
Author(s):  
Yi Xu ◽  
Shen-Min Yang ◽  
Xiao-hua Wang ◽  
Hai-fang Wang ◽  
Mei-e Niu ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Cardiac Function ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Management Strategy ◽  
Intervention Group ◽  
Volume Overload ◽  
Volume Control ◽  
Control Group ◽  
Dialysis Patients ◽  
Volume Management

Heart failure due to volume overload is a major reason for rehospitalization in continuous ambulatory peritoneal dialysis patients. Strict volume control provides better cardiac functions and blood pressure in this population. Volume management, which is a volume control strategy, may decrease volume overload and related complications. Using a quasi-experimental design, 66 continuous ambulatory peritoneal dialysis patients were randomly assigned to the intervention group ( n = 34) and control group ( n = 32). The patients were followed up for 6 months with scheduled clinic and/or telephone visits; the intervention group adopted volume management strategy, while the control group adopted conventional care. Volume overload and cardiac function were compared between the two groups at the baseline and at 6 months. At Month 6, the intervention group resulted in significant improvement in volume overloaded status, cardiac function, and volume-overload-related rehospitalization. Volume management strategy allows for better control of volume overload and is associated with fewer volume-related readmissions.

scholarly journals Carnitine Concentrations in Dialysed and Undialysed Patients with Chronic Renal Insufficiency

1986 ◽  
Vol 23 (6) ◽  
pp. 671-675 ◽  
Author(s):  
S Rodriguez-Segade ◽  
C Alonso De La Peña ◽  
M Paz ◽  
D Novoa ◽  
R Romero ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Renal Insufficiency ◽  
Chronic Renal Insufficiency ◽  
Carnitine Deficiency ◽  
Free Carnitine ◽  
Control Group ◽  
Serum Concentrations ◽  
Total Carnitine ◽  
Haemodialysis Treatment ◽  
Endogenous Synthesis

Free carnitine, acylcarnitine and total carnitine serum concentrations have been measured in chronic renal insufficiency patients under conservative treatment, in patients under regular haemodialysis treatment and in healthy controls. In the undialysed patients the levels of free carnitine, acylcarnitine and total carnitine were all clearly higher than those of the control group. The free carnitine and total carnitine levels of undialysed subjects were also higher than in regularly haemodialysed patients, showing that dialysis produces plasma carnitine losses that are not compensated for by endogenous synthesis of carnitine (this finding supports published reports of tissue carnitine deficiency in patients undergoing regular haemodialysis). The acylcarnitine levels of dialysed and undialysed patients were not significantly different, however; both were very much higher than that of control group. The hypercarnitinaemia of the patients under conservative treatment suggests that the impairment of renal function causes a reduction in the elimination of carnitine via the kidney.

scholarly journals Prevalence of Carnitine Deficiency and Decreased Carnitine Levels in Patients on Peritoneal Dialysis

Nutrients ◽  
2019 ◽  
Vol 11 (11) ◽  
pp. 2645 ◽  
Author(s):  
Satoshi Shimizu ◽  
Hiroyuki Takashima ◽  
Ritsukou Tei ◽  
Tetsuya Furukawa ◽  
Makiyo Okamura ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
High Risk ◽  
Carnitine Deficiency ◽  
Free Carnitine ◽  
Serum Concentrations ◽  
Clinical Factors ◽  
Carnitine Level ◽  
Serum Free ◽  
Factors Associated ◽  
Carnitine Concentration

Background: Carnitine deficiency is common in patients on dialysis. Serum free carnitine concentration is significantly lower in patients on hemodialysis (HD) than in healthy individuals. However, there are few reports on serum free carnitine concentration in patients on peritoneal dialysis (PD). Methods: We examined serum concentrations of total, free, and acylcarnitine and the acylcarnitine/free carnitine ratio in 34 PD and 34 age-, sex-, and dialysis duration-matched HD patients. We investigated the prevalence of carnitine deficiency and clinical factors associated with carnitine deficiency in the PD group. Results: Prevalence of carnitine deficiency was 8.8% in the PD group and 17.7% in the HD group (p = 0.283). High risk of carnitine deficiency was found in 73.5% of the PD group and 76.4% of the HD group (p = 0.604). Carnitine insufficiency was found in 82.3% of the PD group and 88.2% of HD group (p = 0.733). Multivariate analysis revealed that duration of dialysis and age were independent predictors of serum free carnitine level in the PD group. Conclusions: The prevalence of carnitine deficiency, high risk of carnitine deficiency, and carnitine insufficiency in PD patients was 8.8%, 73.5%, and 82.3%, respectively. These rates were comparable to those in patients on HD.

scholarly journals Significance of Levocarnitine Treatment in Dialysis Patients

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1219
Author(s):  
Hiroyuki Takashima ◽  
Takashi Maruyama ◽  
Masanori Abe
Keyword(s):  
Dietary Intake ◽  
Carnitine Deficiency ◽  
Free Carnitine ◽  
Amino Acid Derivative ◽  
Long Chain Fatty Acids ◽  
Dialysis Patients ◽  
Naturally Occurring ◽  
Clinical Disorders ◽  
Liver And Kidney ◽  
Endogenous Synthesis

Carnitine is a naturally occurring amino acid derivative that is involved in the transport of long-chain fatty acids to the mitochondrial matrix. There, these substrates undergo β-oxidation, producing energy. The major sources of carnitine are dietary intake, although carnitine is also endogenously synthesized in the liver and kidney. However, in patients on dialysis, serum carnitine levels progressively fall due to restricted dietary intake and deprivation of endogenous synthesis in the kidney. Furthermore, serum-free carnitine is removed by hemodialysis treatment because the molecular weight of carnitine is small (161 Da) and its protein binding rates are very low. Therefore, the dialysis procedure is a major cause of carnitine deficiency in patients undergoing hemodialysis. This deficiency may contribute to several clinical disorders in such patients. Symptoms of dialysis-related carnitine deficiency include erythropoiesis-stimulating agent-resistant anemia, myopathy, muscle weakness, and intradialytic muscle cramps and hypotension. However, levocarnitine administration might replenish the free carnitine and help to increase carnitine levels in muscle. This article reviews the previous research into levocarnitine therapy in patients on maintenance dialysis for the treatment of renal anemia, cardiac dysfunction, dyslipidemia, and muscle and dialytic symptoms, and it examines the efficacy of the therapeutic approach and related issues.

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