Effect of carnitine supplementation on lipid profile and anemia in children on chronic dialysis.
We prospectively evaluated the effects of L-carnitine supplementation on plasma free carnitine (FC) levels, serum lipid profile, and erythropoietin (rhEPO) requirement in 24 children treated with peritoneal dialysis (PD; n=16) or hemodialysis (HD; n=8). The study was divided into a 3-month observation period, and a 3-month treatment period during which patients received 20 mg/kg per day of L-carnitine given orally. Clinical, biochemical, and hematological data were collected every 3 months. FC levels were measured in plasma and peritoneal dialysate by tandem mass spectrometry. There were no statistically significant changes in lipid levels, hemoglobin, or rhEPO requirements during the course of the study. Fifteen patients (13 PD, 2 HD) had plasma FC levels measured before and after treatment; FC levels increased from 32.1 +/- 14.1 micromol/l to 80.9 +/- 38.7 micromol/l (P<0.001). In PD patients, dialysate FC losses increased from 106 +/- 78 micromol/day at baseline to 178 +/- 119 micromol/day after supplementation. Positive correlations between FC plasma levels and dialysate levels (R=0.507) or daily excretion (R=0.603) were found after treatment. In our case series, an oral dose of 20 mg/kg per day of L-carnitine restored FC levels and produced a positive carnitine balance with no significant effects on hematological parameters or lipid profile over a 3-month period. Prolonged treatment duration may be required to obtain significant results.
Verrina
Enrico
E
Nephrology and Dialysis Unit, G. Gaslini Institute, Largo G. Gaslini, 5, 16148, Genova, Italy. enricoverrina@ospedale-gaslini.ge.it
Caruso
Ubaldo
U
Calevo
Maria Grazia
MG
Emma
Francesco
F
Sorino
Palma
P
De Palo
Tommaso
T
Lavoratti
Giancarlo
G
Turrini Dertenois
Laura
L
Cassanello
Michela
M
Cerone
Roberto
R
Perfumo
Francesco
F
D000293:Adolescent; D000740:Anemia / Q000097:blood* / Q000188:drug therapy; D002331:Carnitine / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D002648:Child; D019587:Dietary Supplements; D004921:Erythropoietin / Q000627:therapeutic use; D006400:Hematocrit; D006801:Humans; D008055:Lipids / Q000097:blood*; D018579:Patient Selection; D010530:Peritoneal Dialysis; D011446:Prospective Studies; D006435:Renal Dialysis
D008055:Lipids; D004921:Erythropoietin; D002331:Carnitine