Plasma carnitine as a marker of protein malnutrition.
ASN 30th Annual Meeting, San Antonio
J Am Soc Nephrol (Sep) 8:230A 1997
In this study, the relationship between predialysis plasma levels of carnitine and nutritional and dialysis parameters were obtained. Plasma and total free carnitine levels were assessed in 194 hemodialysis patients treated for 5 to 8 hours 3 times per week. Baseline data include an nPCR of 1.17, a daily energy intake of 27.9 kcal/kg, a daily protein intake of 1.18 g/kg, a serum albumin level of 3.8 g/dl and a dose of dialysis by the Daugirdas index of 2.03.
The plasma level of total carnitine was 44.1 ± 1.2 moles/l in this group, and 19% of patients had a level below 30 moles/l. Total plasma carnitine levels were positively correlated with protein intake either estimated from PCR calculation or from 3-day food records and negatively associated by age. Plasma carnitine levels were not correlated with years on hemodialysis years, body mass index, Daugirdas index, URR, or daily energy intake. There was no difference in plasma carnitine levels based on the use of acetate or bicarbonate dialysis or the hemodialysis prescription time. In addition, there was a strong correlation between carnitine levels and predialytic urea, creatinine, and albumin levels. There was no association with C reactive protein total cholesterol or triglyceride levels.
It was felt that patients with low carnitine levels had a low protein intake with protein malnutrition. It was felt that this marker was not influenced by either dialysis adequacy parameters or inflammatory proteins. It was felt that this parameter may be used as a surrogate of protein nutrition that has the advantage of not being influenced by inflammatory states. Michael V. Rocco, M.D., Bowman Gray School of Medicine
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ASN 30th Annual Meeting, San Antonio
CRF by organ system : Nutrition