Document Detail


Carnitine metabolism in uremia.
MedLine Citation:
PMID:  11576925     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Carnitine is a conditionally essential metabolite that plays a critical role in cell physiology by participating in transesterification reactions and preventing organic acid accumulation. A number of disease states are characterized by carnitine depletion that may lead to metabolic and clinical disturbances. In maintenance hemodialysis, carnitine is lost through dialytic membranes, leading in selected patients to carnitine depletion with a relative increase of the esterified forms. Carnitine supplementation after or during dialysis counteracts such alterations and may be associated with some clinical benefits. Recent meta-analyses of the literature indicate that carnitine supplementation in hemodialysis patients may improve the hematological status (allowing a reduction of the requirement for erythropoietin), the exercise tolerance, the plasma lipid profile, and the intradialytic symptoms. In addition, carnitine supplementation may improve cardiac functions, protein metabolism, and insulin resistance. Carnitine supplementation has been recently approved by the US Food and Drug Administration not only for the treatment, but also for the prevention of carnitine depletion in dialysis patients. Furthermore, clinical guidelines developed by both American and European nephrological societies suggest that a trial with carnitine supplementation could be recommended in selected dialysis patients who do not adequately respond to standard therapy for certain conditions, such as severe and persistent muscle cramps or hypotension during dialysis, lack of energy affecting quality of life, skeletal muscle weakness or myopathy, cardiomyopathy, and anemia of uremia unresponsive to or requiring large doses of erythropoietin.
Authors:
G Guarnieri; R Situlin; G Biolo
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  American journal of kidney diseases : the official journal of the National Kidney Foundation     Volume:  38     ISSN:  1523-6838     ISO Abbreviation:  Am. J. Kidney Dis.     Publication Date:  2001 Oct 
Date Detail:
Created Date:  2001-09-28     Completed Date:  2001-12-04     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  8110075     Medline TA:  Am J Kidney Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  S63-7     Citation Subset:  IM    
Affiliation:
Department of Clinical, Morphological and Technological Sciences, Division of Internal Medicine, University of Trieste, Trieste, Italy. gianfrang @clmed.univ.trieste.it
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MeSH Terms
Descriptor/Qualifier:
Carnitine / administration & dosage,  deficiency,  metabolism*
Cytoplasm / metabolism
Humans
Kidney Failure, Chronic / metabolism*,  therapy
Mitochondria / metabolism
Peritoneal Dialysis, Continuous Ambulatory
Renal Dialysis
Uremia / metabolism,  therapy
Chemical
Reg. No./Substance:
541-15-1/Carnitine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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