title: Absolute and Relative Carnitine Deficiency in Patients on Hemodialysis and Peritoneal Dialysis.
abstract: BACKGROUND
  Carnitine deficiency is commonly seen in dialysis patients. This study assessed the association dialysis and pediatric patients' characteristics with plasma carnitines levels.
  
  
  METHODS
  Plasma carnitine concentrations were measured by tandem mass spectrometry in 46 children on hemodialysis or peritoneal dialysis. The total carnitine, free carnitine (FC), and L-acyl carnitine (AC) levels of 40 µmol/L and less, less than 7 µmol/L, and less than 15 µmol/L were defined low, respectively. An FC less than 20 µmol/L and an AC/FC ratio greater than 0.4 were considered as absolute and relative carnitine deficiencies. The correlation between carnitines levels and AC/FC ratio and age, duration of dialysis, characteristics of dialysis, and blood urea nitrogen and serum albumin concentrations were assessed.
  
  
  RESULTS
  Absolute carnitine deficiency, low total carnitine, and low AC concentrations were found in 66.7%, 82.6%, and 51% of the patients, respectively. All of the patients had relative carnitine deficiency. Carnitine measurements were not significantly different between the hemodialysis and peritoneal dialysis groups. More severe relative carnitine deficiency was found in those with lower blood urea nitrogen levels and those on peritoneal dialysis. No linear correlation was found between carnitine levels and age, duration of dialysis, characteristics of dialysis, serum albumin level, or blood urea nitrogen level.
  
  
  CONCLUSIONS
  Absolute and relative carnitine deficiencies are common among children on dialysis. Patients with lower blood urea nitrogen levels and peritoneal dialysis patients are more prone to severe relative carnitine deficiency.
authors.affiliation: Department of Pediatric Nephrology, Dr Sheikh Children Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. naserim@mums.ac.ir.
authors.forename: Mitra
authors.initials: M
authors.lastname: Naseri
authors.forename: Hasan
authors.initials: H
authors.lastname: Mottaghi Moghadam Shahri
authors.forename: Mohsen
authors.initials: M
authors.lastname: Horri
authors.forename: Mohammad
authors.initials: M
authors.lastname: Esmaeeli
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Ghaneh Sherbaf
authors.forename: Shohre
authors.initials: S
authors.lastname: Jahanshahi
authors.forename: Giti
authors.initials: G
authors.lastname: Moeenolroayaa
authors.forename: Zahra
authors.initials: Z
authors.lastname: Rasoli
authors.forename: Farzaneh
authors.initials: F
authors.lastname: Salemian
authors.forename: Maryam
authors.initials: M
authors.lastname: Pour Hasan
mesh_terms: D000293:Adolescent; D001806:Blood Urea Nitrogen; D002331:Carnitine / Q000031:analogs & derivatives* / Q000097:blood / Q000172:deficiency*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects; D006435:Renal Dialysis / Q000009:adverse effects*; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000628:therapy*; D055815:Young Adult
chemical_list: C116917:acylcarnitine; D002331:Carnitine