Perturbation of serum carnitine levels in human adults by chronic renal disease and dialysis therapy

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Abstract
Serum carnitine levels in nondialyzed and dialyzed patients with chronic renal disease were compared against a group of normal control subjects. The concentration of serum carnitine was directly correlated with that of serum creatinine (r = +0.734; p < 0.001). In nondialyzed uremic patients the serum free carnitine levels in males rose 218% (p < 0.001) and in females rose 186% (p < 0.001) above normal control values. During dialysis there was a sharp decline in serum carnitine to levels reaching 20% of the zero time control value (p < 0.001). The decrease in serum carnitine could be accounted for by an almost quantitative accumulation of carnitine in the dialysate fluid. After termination of dialysis there was a hyperbolic rise in serum carnitine which reached the high values again within 44 to 48 h. It is postulated that frequent perturbations in serum carnitine as a result of chronic dialysis therapy over a prolonged time period could potentially lead to a tissue deficiency in carnitine with its resultant complications.

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