SULM – Schweizerische Union für Labormedizin | Union Suisse de Médecine de Laboratoire | Swiss Union of Laboratory Medicine

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R. Cibulka *1 , J. Racek1 , L. Trefil1 , E. Veselá2 , M. Studenovská3 , D. Rajdl1

1Institiute of Clinical Biochemistry and Hematology, Charles University Hospital, Alej Svobody 80, Pilsen, 304 60 *, 2Hemodialysis Center EuroCare, E.Beneše 9, Pilsen, 304 46, 3Hemodialysis Center EuroCare, U nemocnice 3064, Teplice, 415 01

OBJECTIVE: The deficit of L-carnitine (CAR) in chronic hemodialysis (HD) patients leads to a disorder of energetic metabolism. The aim of our study is to compare serum concentrations of free CAR in HD patients (before and after HD) and healthy population and evaluate their changes in consequence of its supplementation.
METHODS: We observed 85 HD patients and 68 healthy control subjects. The levels of CAR were measured in HD patients before the study (these values were compared with controls), after 3 and 6 months of supplementation (always before and after HD). 46 HD patients were supplemented by CAR (15 mg/kg i.v. after each HD), 39 HD patients took placebo. Free CAR in serum was determined by enzymatic photometric test from Roche.
RESULTS: The average CAR concentration (values in umol/l) in healthy persons was 40.1 ± 8.9, in HD patients 30.5 ± 10.3 before HD (p < 0.001). Values after HD decreased to 9.4 ± 4.6 (p < 0.001 vs. predialysis values). Both subgroups of HD patients had comparable levels of CAR in serum at the beginning of the study. While this value markedly increased after 3 and 6 months of supplementation (29.5 ± 8.7 vs. 135.3 ± 39.9 vs. 111.7 ± 35.7; p < 0.001), there was a tendency to a decrease in non-supplemented subgroup (30.4 ± 11.5 vs. 30.2 ± 12.5 vs. 25.7 ± 10.0; non-significant . The levels of CAR were still higher 2 months after the supplementation had ended (65.0 ± 16.6; p < 0.01 vs. initial values).
CONCLUSION: About 60% of the patients before HD had a significant deficit of free CAR in serum. The others had comparable values with the healthy population. All observed patients had lower values of CAR after HD (approximately 30% of the value before HD). There was a high increase after CAR supplementation, so that the values after HD were within reference ranges for healthy population. These higher levels still remained 2 months after the end of supplementation.
This study was supported by the IGA MH CR grant No NB/7350-3

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