Serum carnitine levels and carnitine esters of patients after kidney transplantation: role of immunosuppression.
Serum levels of carnitine and carnitine esters were measured in different groups of patients after cadaveric renal transplantation and compared with those of healthy subjects as well as azotemic and uremic patients. In all groups of patients serum levels of total carnitine (TC), free carnitine (FC), short-chain acylcarnitine (SCC), and long-chain acylcarnitine (LCC) increased with reduction of kidney function. However, cyclosporin- and prednisone-treated transplant patients with impaired kidney function displayed significantly higher TC, FC, and SCC compared with transplant patients under immunosuppression with azathioprine and prednisone. This group of cyclosporin-treated patients showed also significantly elevated serum cholesterol suggesting that carnitine deficiency is not responsible for the observed abnormalities in lipid metabolism after renal transplantation. Urinary excretion of TC, FC, SCC, and LCC decreased with reduction of kidney function without differences between cyclosporin- and azathioprine-treated patients. Single dose L-carnitine administration (10 mg/kg body weight IV) resulted in significantly higher TC, FC, SCC, and LCC values of azotemic patients with and without immunosuppression than in healthy subjects. Acylation of the administered carnitine was comparable in healthy controls and azotemic patients. Increased values of short-chain and long-chain acylcarnitine, therefore, seem to depend on the excretion of the diseased kidney(s). Our data demonstrate abnormalities in carnitine metabolism in patients with impaired kidney function. These alterations are further influenced by immunosuppressive drugs.
Wanner
C
C
Department of Medicine, University of Freiburg, FRG.
Schollmeyer
P
P
Hörl
W H
WH
D000215:Acylation; D000293:Adolescent; D000328:Adult; D000368:Aged; D002331:Carnitine / Q000097:blood*; D002784:Cholesterol / Q000097:blood; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology*; D007668:Kidney / Q000378:metabolism; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged
D007166:Immunosuppressive Agents; D002784:Cholesterol; D002331:Carnitine