Perturbation of serum carnitine levels in human adults by chronic renal disease and dialysis therapy.

Serum carnitine levels in nondialyzed and dialyzed patients with chronic renal disease were compared against a group of normal control subjects. The concentration of serum carnitine was directly correlated with that of serum creatinine (r = +0.734; p less than 0.001). In nondialyzed uremic patients the serum free carnitine levels in males rose 218% (p less than 0.001) and in females rose 186% (p less than 0.001) above normal control values. During dialysis there was a sharp decline in serum carnitine to levels reaching 20% of the zero time control value (p less than 0.001). The decrease in serum carnitine could be accounted for by an almost quantitatively accumulation of carnitine in the dialysate fluid. After termination of dialysis there was a hyperbolic rise in serum carnitine which reached the high values again within 44 to 48 h. It is postulated that frequent perturbations in serum carnitine as a result of chronic dialysis therapy over a prolonged time period could potentially lead to a tissue deficiency in carnitine with its resultant complications.