Blood Purif. 2019;47 Suppl 2:38-44. doi: 10.1159/000496720. Epub 2019 Apr 3.
Prevalence of Carnitine Deficiency and Decreased Carnitine Levels in Patients on Hemodialysis.
Hatanaka Y1, Higuchi T2, Akiya Y1, Horikami T1, Tei R1, Furukawa T1, Takashima H1, Tomita H3, Abe M4.
Division of Nephrology, Hypertension and Endocrinology, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan.
Department of Nephrology, Keiai Hospital, Tokyo, Japan.
Department of Nephrology, Yujin Clinic, Tokyo, Japan.
Division of Nephrology, Hypertension and Endocrinology, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan, abe.masanori@nihon-u.ac.jp.
Patients on hemodialysis (HD) are known to be at risk of carnitine deficiency. The aims of this study were to investigate the prevalence of carnitine deficiency in patients on dialysis and to compare the likelihood of a reduction in the serum carnitine level on HD with that on hemodiafiltration (HDF).
The prevalence of carnitine deficiency, defined as a serum free carnitine level < 20 μmol/L, and that of carnitine insufficiency, defined as an acyl/free carnitine ratio > 0.4, was investigated in 150 patients on dialysis. The reduction rate of serum carnitine was then compared between HD and HDF.
The prevalence of carnitine deficiency and that of carnitine insufficiency was 25.3 and 86.7%, respectively. Patients at high risk of carnitine deficiency accounted for 64.7%. Multivariate regression identified an association of duration of dialysis with the free serum carnitine level. The reduction rates of serum free carnitine in HD and HDF were 64 ± 4 and 75 ± 7%, respectively (p < 0.0001).
The prevalence rates of carnitine deficiency and carnitine insufficiency were high in patients on dialysis. The serum carnitine reduction rate was greater with HDF than with HD.
© 2019 S. Karger AG, Basel.
Carnitine; Hemodiafiltration; Hemodialysis; Predilution; Reduction rate
Carnitine/blood*
Carnitine/deficiency*
Hemodiafiltration*/adverse effects
Japan/epidemiology
Kidney Failure, Chronic/blood*
Kidney Failure, Chronic/complications
Kidney Failure, Chronic/epidemiology
Kidney Failure, Chronic/therapy
Renal Dialysis*/adverse effects
S. Karger AG, Basel, Switzerland
Carnitine Deficiency - Genetic Alliance
Kidney Failure - MedlinePlus Health Information
Dialysis - MedlinePlus Health Information