Lorenzo Di Liberato1, Arduino Arduini2, Claudia Rossi3, Augusto Di Castelnuovo4, Cosima Posari1, Paolo Sacchetta3, Andrea Urbani5,6, Mario Bonomini7. 1. Department of Medicine, Institute of Nephrology, "SS. Annunziata" Hospital, G. d'Annunzio University of Chieti-Pescara, Via dei Vestini, 66013, Chieti, Italy. 2. Department of Research and Development, CoreQuest Sagl, Tecnopolo, Bioggio, Switzerland. 3. Department of Experimental and Clinical Sciences, G. d'Annunzio University of Chieti-Pescara, Chieti, Italy. 4. Unit of Molecular and Nutritional Epidemiology, Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli, Italy. 5. Department of Internal Medicine, University Tor Vergata, Rome, Italy. 6. IRCCS-Santa Lucia Foundation, Rome, Italy. 7. Department of Medicine, Institute of Nephrology, "SS. Annunziata" Hospital, G. d'Annunzio University of Chieti-Pescara, Via dei Vestini, 66013, Chieti, Italy. m.bonomini@nephro.unich.it.
Abstract
BACKGROUND: Carnitine metabolism in patients on peritoneal dialysis (PD), particularly automated PD (APD), has not been extensively evaluated. Here, we examined levels of a large number of carnitine species in plasma from adult uremic patients treated with continuous ambulatory PD (CAPD) or APD, vetting whether L-carnitine may be used in the solution bag for APD therapy. METHODS: Plasma levels of carnitine and its esters were measured by high-performance liquid chromatography/tandem quadrupole mass spectrometry in 14 patients on CAPD (3 × 1.5 % glucose daily and icodextrin overnight), 16 patients on APD (tidal modality), and 8 age- and gender-matched healthy controls. PD groups did not differ with regard to demographic characteristics, renal function, dialysis features, peritoneal function, or biochemistry. In five APD patients, we also examined the safety and efficacy of L-carnitine (5 g) addition to one night-dwell solution bag over five consecutive days. RESULTS: Several abnormalities were found in plasma carnitine species of PD patients as compared to controls, mainly represented by a reduction of free carnitine and an increase in acetyl-carnitine, dicarboxylic and other carnitines. The main carnitine species (free carnitine, acetyl-carnitine) were significantly lower in plasma from APD than CAPD patients. APD patients tolerated L-carnitine supplementation well, laboratory, physical and dialysis parameters proving stable. CONCLUSIONS: Plasma carnitine metabolism is abnormal in patients on PD, and may be influenced by the PD modality. Given the good tolerability and potential advantages of carnitine used in the PD fluid, L-carnitine-containing solution bags in APD treatment definitely merit further evaluation.
BACKGROUND:Carnitine metabolism in patients on peritoneal dialysis (PD), particularly automated PD (APD), has not been extensively evaluated. Here, we examined levels of a large number of carnitine species in plasma from adult uremic patients treated with continuous ambulatory PD (CAPD) or APD, vetting whether L-carnitine may be used in the solution bag for APD therapy. METHODS: Plasma levels of carnitine and its esters were measured by high-performance liquid chromatography/tandem quadrupole mass spectrometry in 14 patients on CAPD (3 × 1.5 % glucose daily and icodextrin overnight), 16 patients on APD (tidal modality), and 8 age- and gender-matched healthy controls. PD groups did not differ with regard to demographic characteristics, renal function, dialysis features, peritoneal function, or biochemistry. In five APDpatients, we also examined the safety and efficacy of L-carnitine (5 g) addition to one night-dwell solution bag over five consecutive days. RESULTS: Several abnormalities were found in plasma carnitine species of PDpatients as compared to controls, mainly represented by a reduction of free carnitine and an increase in acetyl-carnitine, dicarboxylic and other carnitines. The main carnitine species (free carnitine, acetyl-carnitine) were significantly lower in plasma from APD than CAPD patients. APDpatients tolerated L-carnitine supplementation well, laboratory, physical and dialysis parameters proving stable. CONCLUSIONS: Plasma carnitine metabolism is abnormal in patients on PD, and may be influenced by the PD modality. Given the good tolerability and potential advantages of carnitine used in the PD fluid, L-carnitine-containing solution bags in APD treatment definitely merit further evaluation.
Authors: Wieneke M Michels; Marion Verduijn; Alena Parikova; Elisabeth W Boeschoten; Dirk G Struijk; Friedo W Dekker; Raymond T Krediet Journal: Perit Dial Int Date: 2012-04-02 Impact factor: 1.756
Authors: C Chatzidimitriou; T Pliakogiannis; A Evangeliou; T Tsalkidou; H J Böhles; K Kalaitzidis Journal: Perit Dial Int Date: 1993 Impact factor: 1.756
Authors: Mario Bonomini; Victor Zammit; José C Divino-Filho; Simon J Davies; Lorenzo Di Liberato; Arduino Arduini; Mark Lambie Journal: J Nephrol Date: 2020-08-07 Impact factor: 3.902