Document Detail


Levocarnitine and dialysis: a review.
MedLine Citation:
PMID:  16207659     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Among the various metabolic abnormalities documented in dialysis patients are abnormalities related to the metabolism of fatty acids. Aberrant fatty-acid metabolism has been associated with the promotion of free-radical production, insulin resistance, and cellular apoptosis. These processes have been identified as important contributors to the morbidity experienced by dialysis patients. There is evidence that levocarnitine supplementation can modify the deleterious effects of defective fatty-acid metabolism. Patients receiving hemodialysis and, to a lesser degree, peritoneal dialysis have been shown to be carnitine deficient, as manifested by reduced levels of plasma free carnitine and an increase in the acyl:free carnitine ratio. Cardiac and skeletal muscles are particularly dependent on fatty-acid metabolism for the generation of energy. A number of clinical abnormalities have been correlated with a low plasma carnitine status in dialysis patients. Clinical trials have examined the efficacy of levocarnitine therapy in a number of conditions common in dialysis patients, including skeletal-muscle weakness and fatigue, cardiomyopathy, dialysis-related hypotension, hyperlipidemia, and anemia poorly responsive to recombinant human erythropoietin therapy (rHuEPO). This review examines the evidence for carnitine deficiency in patients requiring dialysis, and documents the results of relevant clinical trials of levocarnitine therapy in this population. Consensus recommendations by expert panels are summarized and contrasted with present guidelines for access to levocarnitine therapy by dialysis patients.
Authors:
Brian Schreiber
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition     Volume:  20     ISSN:  0884-5336     ISO Abbreviation:  Nutr Clin Pract     Publication Date:  2005 Apr 
Date Detail:
Created Date:  2005-10-06     Completed Date:  2005-11-15     Revised Date:  2010-04-29    
Medline Journal Info:
Nlm Unique ID:  8606733     Medline TA:  Nutr Clin Pract     Country:  United States    
Other Details:
Languages:  eng     Pagination:  218-43     Citation Subset:  IM; N    
Affiliation:
Dialysis Care, Department of Medicine, Division of Nephrology, Medical College of Wisconsin, Milwaukee, WI, USA. bdschreib@new.rr.com
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MeSH Terms
Descriptor/Qualifier:
Carnitine / deficiency*,  therapeutic use*
Fatty Acids / metabolism*
Humans
Kidney Failure, Chronic / drug therapy*,  metabolism
Renal Dialysis* / adverse effects
Chemical
Reg. No./Substance:
0/Fatty Acids; 541-15-1/Carnitine

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


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