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Abstract: SA-PO1063

1500-Day All-Cause Mortality and Carnitine Profile in Hemodialysis Patients

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1302 Health Maintenance, Nutrition, and Metabolism: Clinical

Authors

  • Kamei, Daigo, Tokyo Women's Medical University, Tokyo, Japan
  • Kamei, Yuiko, Tokyo Metropolitan Health and Medical Treatment Corporation, Tokyo, Japan
  • Tsuchiya, Ken, Tokyo Women's Medical University, Tokyo, Japan
  • Nitta, Kosaku, Tokyo Women's Medical University, Tokyo, Japan
  • Mineshima, Michio, Tokyo Women's Medical University, Tokyo, Japan
Background

Patients on dialysis are in a chronic carnitine-deficient state. This condition may be associated with abnormalities of the fatty acid and organic acid metabolisms. Carnitine is required for β-oxidation of the long-chain fatty acids; therefore, carnitine deficiency decreases the efficiency of ATP synthesis and may incur death. However, the details of this association remain unknown. We examined the relationship between β-oxidation efficiency represented by the carnitine profile and 1500-day all-cause mortality in hemodialysis patients.

Methods

The carnitine profiles of 122 hemodialysis patients were determined by liquid chromatography-tandem mass spectrometry (LC-MS/MS). The associations between 1500-day all-cause mortality and carnitine profile as well as the clinical backgrounds of the patients were investigated. A survival analysis was conducted by the Kaplan-Meier survival method and multivariate Cox proportional hazard analysis. The bootstrap method was performed to confirm the stability and robustness of our model.

Results

Of the 122 subjects analyzed, 111 were selected and 24 died during the observation period. Stepwise multivariate Cox regression demonstrated that diabetes state [p < 0.001, exp(β) = 4.981], age [p = 0.006, exp (β) = 1.052], and the acetylcarnitine/(palmitoylcarnitine+octadecenoylcarnitine) [C2/(C16+C18:1)] ratio [p < 0.001, exp(β) = 0.937] were independent significant factors of 1500-day all-cause mortality. The bootstrap method confirmed the significance of these three factors.

Conclusion

The 1500-day all-cause mortality negatively correlated with the C2/(C16+C18:1) ratio. Improvement of the impaired β-oxidation state after L-carnitine administration may ameliorate prognosis.