Fatty acid abnormalities in hemodialysis patients: effect of L-carnitine administration.

Serum fatty acid profiles were determined using gas chromatography/mass spectrometry in three groups of subjects. Compared to normal controls, eight patients on maintenance hemodialysis had significantly lower proportions of linoleic (28.15 +/- 1.3 vs. 26.5 +/- 1.4%, P less than 0.003), linolenic (0.49 +/- 0.2 vs. 0.21 +/- 0.2%, P less than 0.04) and arachidonic acids (8.42 +/- 0.9 vs. 6.0 +/- 1.5%, P less than 0.0001). Dialysis patients also had higher proportions of oleic (8.9 +/- 1.8 vs. 15.3 +/- 3.5%, P less than 0.0001) and n-9 eicosatrienoic acids (0.26 +/- 0.2 vs. 0.54 +/- 0.3%, P less than 0.04). Ratios between oleic and arachidonic acid and between eicosatrienoic and arachidonic acids were also significantly higher in the dialysis group. In a separate group of either chronic dialysis patients, L-carnitine was given intravenously for a period of 6 to 18 months. In this group linoleic, linolenic and eicosatrienoic acids were not significantly different from normal controls. The ratio between eicosatrienoic and arachidonic acids was also similar to normal controls. However, arachidonic acid remained significantly lower and oleic acid significantly elevated in the carnitine group. The ratio of saturated to unsaturated fatty acid was higher in the untreated dialysis patients compared to L-carnitine treated patients (0.75 +/- 0.07 vs. 0.65 +/- 0.06, P less than 0.01). Significant abnormalities in distribution of fatty acids was seen in hemodialyzed patients. Thus preliminary data suggest significant depletion of essential fatty acids in dialysis patients which is partially corrected by treatment of patients with L-carnitine.