Effect of L-carnitine on the kinetics of carnitine, acylcarnitines and butyrobetaine in long-term haemodialysis.

doi:10.1093/NDT/GFI257

Paper

Effect of L-carnitine on the kinetics of carnitine, acylcarnitines and butyrobetaine in long-term haemodialysis.

Published Feb 1, 2006 · L. Vernez, M. Dickenmann, J. Steiger

Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association

Q1 SJR score

30

Citations

2

Influential Citations

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Abstract

BACKGROUND The current study was performed to investigate the kinetics of carnitine, individual acylcarnitines and butyrobetaine in patients on haemodialysis. METHODS Eight stable long-term haemodialysis patients were studied under basal conditions (no carnitine supplementation) and 3 weeks after intravenous supplementation with l-carnitine (10 or 20 mg/kg body weight) after each haemodialysis session. The kinetic studies included serial determinations of carnitine and metabolites just before, during or between haemodialysis sessions. Analysis was performed by liquid chromatography-tandem mass spectrometry. RESULTS Before haemodialysis, the plasma concentrations were (micromol/l) 15.1+/-0.6 (mean+/-SEM) for carnitine, 5.9+/-0.7 for acetylcarnitine, 0.66+/-0.04 for propionylcarnitine and 0.98+/-0.08 for butyrobetaine (basal conditions) or 142+/-23 for carnitine, 69+/-12 for acetylcarnitine, 6.0+/-1.1 for propionylcarnitine and 2.6+/-0.3 for butyrobetaine (carnitine 20 mg/kg). During haemodialysis, the plasma concentrations dropped by approximately 80% for all compounds determined, with extraction coefficients ranging from 0.65 to 0.86. In patients supplemented with 20 mg/kg carnitine, the amount of carnitine removed by haemodialysis equalled 42% of the dose administered, consisting of 2.08 mmol carnitine, 1.03 mmol acetylcarnitine and 0.051 mmol propionylcarnitine. Between the haemodialysis sessions, carnitine, acylcarnitines and butyrobetaine reached apparent steady-state concentrations within 1 day both under basal conditions and after supplementation. CONCLUSIONS Patients on haemodialysis have reduced carnitine, acylcarnitine and butyrobetaine plasma levels, which can be increased by supplementing carnitine. Propionylcarnitine, an important constituent of the acylcarnitine pool, can be removed by haemodialysis. Removal of potentially toxic acyl-groups may represent a mechanism for a beneficial effect of carnitine in these patients.

Non-RCT

Study Snapshot

L-carnitine supplementation can increase carnitine, acylcarnitine, and butyrobetaine plasma levels in long-term haemodialysis patients, potentially benefiting their health.

PopulationOlder adults (50-71 years)

Sample size24

MethodsObservational

OutcomesBody Mass Index projections

ResultsSocial networks mitigate obesity in older groups.

Paper

Effect of L-carnitine on the kinetics of carnitine, acylcarnitines and butyrobetaine in long-term haemodialysis.

References

Determination of carnitine and acylcarnitines in plasma by high-performance liquid chromatography/electrospray ionization ion trap tandem mass spectrometry.

This method accurately determines carnitine, butyrobetaine, acetylcarnitine, and propionylcarnitine in plasma, aiding in the diagnosis of metabolic disorders.

The role of carnitine in normal and altered fatty acid metabolism.

Carnitine plays a crucial role in fatty acid metabolism, and therapeutic administration shows promise in improving cardiac function, exercise capacity, and reducing muscle cramps in patients with altered carnitine homeostasis.

Carnitine and hemodialysis.

Carnitine supplementation in hemodialysis patients can improve lipid metabolism, protein nutrition, antioxidant status, and reduce the incidence of muscle cramps, hypotension, asthenia, muscle weakness, and cardiomyopathy.

Effects of L-carnitine supplementation in maintenance hemodialysis patients: a systematic review.

L-carnitine supplementation shows promise in anemia management for maintenance hemodialysis patients, but cannot be recommended for treating dyslipidemia.

Carnitine biosynthesis in mammals.

Carnitine biosynthesis in mammals, particularly humans and rats, is regulated by enzymes, molecular mechanisms, and regulatory factors, ensuring energy metabolism and fatty acid breakdown.

Citations

Serum carnitine concentration and the acyl to free carnitine ratio in nondialysis chronic kidney disease and hemodialysis patients

Long-term hemodialysis exacerbates absolute carnitine deficiency, while hemodialysis treatment may improve impaired fatty acid metabolism in nondialysis patients.

Effect of lifelong carnitine supplementation on plasma and tissue carnitine status, hepatic lipid metabolism and stress signalling pathways and skeletal muscle transcriptome in mice at advanced age

Lifelong carnitine supplementation prevents age-related impairment of plasma carnitine status, and safety concerns associated with doses used in clinical trials are unfounded.

l-carnitine in critically ill patients—a case series study

Carnitine depletion is common in critically ill patients, with low BMI and high SOFA scores as potential risk factors for reduction, and CRRT patients showing impaired carnitine metabolism.

Neuroprotective Epigenetic and DNA Damage Repairing Molecular Mechanisms of L-Carnitine and its Congeners against Aging and Age-Related Neurodegenerative Diseases

L-Carnitine and its congeners show neuroprotective epigenetic and DNA damage repair mechanisms against aging and age-related neurodegenerative diseases.

Identification of Rare Variants in Metabolites of the Carnitine Pathway by Whole Genome Sequencing Analysis

Whole genome sequencing identifies two genes, FGF8 and MDGA2, with significant effects on carnitine-related metabolites, but single variant analyses do not identify a single low-frequency variant responsible for the underlying signal.