Clinical significance of different carnitine levels for improving the prognosis of patients undergoing hemodialysis. (25th November 2016)

• Record Type: Journal Article
• Authors: Zhang, Yu-Mei; Zhuo, Li; Hu, Jing; Cui, Gang; Zhang, Ling; Zhang, Xiang-Lin; Li, Wen-Ge
• Is Part Of: Renal failure. Volume 38:Number 10(2016)
• Page Start: 1654
• Page End: 1658
• Publication Date: 2016-11-25
• Subjects: Carnitine -- maintenance hemodialysis -- weakness -- hypotension -- muscle cramps; Chronic renal failure -- Periodicals; Acute renal failure -- Periodicals; Uremia -- Periodicals; 616.614005
• DOI: 10.1080/0886022X.2016.1229967
• Languages: English
• ISSNs: 0886-022X

Abstract

Abstract: Objective: To investigate plasma-free carnitine (Fc), acylcarnitine (Ac), and total carnitine (Tc) levels in patients undergoing hemodialysis (HD), and to explore their clinical significance. Methods: A total of 20 subjects were in the normal control group and 133 patients undergoing HD were divided into medicated (received carnitine treatment) and non-medicated groups. The medicated group was further divided into three subgroups according to Fc level: Fc = 80–199, 200–299, and ≥ 300 μmol/L. We used non-derivative tandem mass spectrometry to determine carnitine levels, and clinical symptoms such as weakness, hypotension, and muscle cramps were recorded during dialysis. Results: Fc and Tc levels were significantly lower in the non-medicated group than in the control group, whereas Fc, Ac, and Tc levels were higher in the medicated than non-medicated group ( p< .05). The medicated group had fewer symptoms during dialysis than the non-medicated group such as weakness, hypotension, and muscle cramps ( p< .05). An additional comparison showed that the incidence rates of hypotension and muscle cramps in the Fc < 80–199 μmol/L group were significantly lower than those in the Fc ≥ 300 μmol/L medicated and non-medicated groups. Conclusions: Patients undergoing HD have low carnitine levels.l -Carnitine can effectively increase Fc concentration and improve clinical symptoms; however, only the proper Fc range can reduce complications caused by dialysis. Thus, this range needs to be determined.