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Carnitine and hemodialysis.

Abstract

Carnitine, gamma-trimethyl-beta-hydroxybutyrobetaine, is a small molecule widely present in all cells from prokaryotic to eukaryotic. It is an important element in the beta-oxidation of fatty acids. A lack of carnitine in hemodialysis patients is caused by insufficient carnitine synthesis and particularly by the loss through dialytic membranes, leading in some patients to carnitine depletion with a relative increase of esterified forms. The authors found a decrease in plasma-triglyceride and increase of high-density lipoprotein cholesterol (HDL-Chol) in dialysis patients during carnitine treatment. Many studies have shown that L-carnitine supplementation leads to improvements in several complications seen in uremic patients, including cardiac complications, impaired exercise and functional capacities, muscle symptoms, increased symptomatic intradialytic hypotension, and erythropoietin-resistant anemia, normalizing the reduced carnitine palmitoyl transferase activity in red cells. In addition, carnitine supplementation may improve protein metabolism and insulin resistance. Recently, carnitine supplementation has been approved by the US Food and Drug Administration not only for the treatment, but also for the prevention of carnitine depletion in dialysis patients. Regular carnitine supplementation in hemodialysis patients can improve their lipid metabolism, protein nutrition, antioxidant status, and anemia requiring large doses of erythropoietin, It also may reduce the incidence of intradialytic muscle cramps, hypotension, asthenia, muscle weakness, and cardiomyopathy.

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  • Authors+Show Affiliations

    ,

    Division of Nephrology, University of Messina, Italy.

    , , ,

    Source

    MeSH

    Carnitine
    Humans
    Renal Dialysis
    Uremia

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    12612967

    Citation

    Bellinghieri, Guido, et al. "Carnitine and Hemodialysis." American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, vol. 41, no. 3 Suppl 1, 2003, pp. S116-22.
    Bellinghieri G, Santoro D, Calvani M, et al. Carnitine and hemodialysis. Am J Kidney Dis. 2003;41(3 Suppl 1):S116-22.
    Bellinghieri, G., Santoro, D., Calvani, M., Mallamace, A., & Savica, V. (2003). Carnitine and hemodialysis. American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, 41(3 Suppl 1), pp. S116-22.
    Bellinghieri G, et al. Carnitine and Hemodialysis. Am J Kidney Dis. 2003;41(3 Suppl 1):S116-22. PubMed PMID: 12612967.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Carnitine and hemodialysis. AU - Bellinghieri,Guido, AU - Santoro,Domenico, AU - Calvani,Menotti, AU - Mallamace,Agostino, AU - Savica,Vincenzo, PY - 2003/3/4/pubmed PY - 2003/3/15/medline PY - 2003/3/4/entrez SP - S116 EP - 22 JF - American journal of kidney diseases : the official journal of the National Kidney Foundation JO - Am. J. Kidney Dis. VL - 41 IS - 3 Suppl 1 N2 - Carnitine, gamma-trimethyl-beta-hydroxybutyrobetaine, is a small molecule widely present in all cells from prokaryotic to eukaryotic. It is an important element in the beta-oxidation of fatty acids. A lack of carnitine in hemodialysis patients is caused by insufficient carnitine synthesis and particularly by the loss through dialytic membranes, leading in some patients to carnitine depletion with a relative increase of esterified forms. The authors found a decrease in plasma-triglyceride and increase of high-density lipoprotein cholesterol (HDL-Chol) in dialysis patients during carnitine treatment. Many studies have shown that L-carnitine supplementation leads to improvements in several complications seen in uremic patients, including cardiac complications, impaired exercise and functional capacities, muscle symptoms, increased symptomatic intradialytic hypotension, and erythropoietin-resistant anemia, normalizing the reduced carnitine palmitoyl transferase activity in red cells. In addition, carnitine supplementation may improve protein metabolism and insulin resistance. Recently, carnitine supplementation has been approved by the US Food and Drug Administration not only for the treatment, but also for the prevention of carnitine depletion in dialysis patients. Regular carnitine supplementation in hemodialysis patients can improve their lipid metabolism, protein nutrition, antioxidant status, and anemia requiring large doses of erythropoietin, It also may reduce the incidence of intradialytic muscle cramps, hypotension, asthenia, muscle weakness, and cardiomyopathy. SN - 1523-6838 UR - https://www.unboundmedicine.com/medline/citation/12612967/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S0272638603500762 DB - PRIME DP - Unbound Medicine ER -