Abstract: SA-PO956
L-Carnitine Supplementation Preserves Residual Renal Function in Patients Undergoing Peritoneal Dialysis
Session Information
- Peritoneal Dialysis: Inflammation, Peritoneal Transport
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 703 Dialysis: Peritoneal Dialysis
Authors
- Ito, Sakuya, Kurume University School of Medicine, Kurume, Japan
- Nakayama, Yosuke, Kurume University School of Medicine, Kurume, Japan
- Kaida, Yusuke, Kurume University School of Medicine, Kurume, Japan
- Moriyama, Tomofumi, Kurume University School of Medicine, Kurume, Japan
- Kodama, Goh, Kurume University School of Medicine, Kurume, Japan
- Kurokawa, Yuka, Kurume University School of Medicine, Kurume, Japan
- Yokota, Yunosuke, Kurume University School of Medicine, Kurume, Japan
- Fukami, Kei, Kurume University School of Medicine, Kurume, Japan
Group or Team Name
- Division of Nephrology, Department of Medicine, Kurume University School of Medicine
Background
Residual renal function (RRF) is the most important factor to maintain well-being and quality of life in patients undergoing peritoneal dialysis (PD). Carnitine plays a central role in fatty acid b-oxidation and energy production by transporting long-chain fatty acids from the cytoplasm to the mitochondria. Furthermore, carnitine was reported to inhibit oxidative stress. We recently reported that serum carnitine levels were significantly decreased in patients undergoing PD. Therefore, we investigated the impact of L-carnitine supplementation on peritoneal function and RRF in these patients.
Methods
Total 24 PD patients with a mean age of 62.6 ± 9.5 years and a mean PD duration of 515.1 ± 382.5 days were randomly assigned to the L-carnitine (750 mg/day, n = 12) or control (n = 12) group and followed for 6 months. Serum free carnitine (FC) and acyl-carnitine (AC) levels were determined by enzyme cycling method. Additionally, the following parameters were measured before and after the treatment period: clinical chemistry, peritoneal function, RRF, urine volume, urinary L-FABP, serum LPO, and serum MDA.
Results
Both serum FC and AC levels, which did not differ at baseline between the two groups, significantly increased in the L-carnitine group after treatment (4.7 ± 9.2, 128.2 ± 29.9 and 12.8 ± 3.3, 50.9 ± 16.6 μmol/L, respectively). Both the Δrenal Kt/V and Δurinary volume, which decreased after 6 months in the control group, were preserved in the L-carnitine group (−0.26 ± 0.32 vs −0.02 ± 0.22, p = 0.043; −367.1 ± 473.3 vs 99.2 ± 316.2 mL, p = 0.010, respectively). The Δserum LPO levels were significantly lower in the L-carnitine group (0.33 ± 0.81 vs −0.58 ± 0.67 nmol/mL, p = 0.007), whereas the Δurinary L-FABP and Δserum MDA levels tended to decrease by L-carnitine treatment (19.5 ± 53.7 vs −24.1 ± 65.0 ng/mL, p = 0.087, -0.02 ± 0.04 vs 0.08 ± 0.06 ng/mL, p = 0.177). Furthermore, there was an inverse correlation between Δurinary volume and ΔL-FABP (r2 = 0.585, p = 0.004) in the L-carnitine group.
Conclusion
L-carnitine supplementation is a promising therapeutic strategy for maintaining RRF by alleviating oxidative stress in L-carnitine-deficient patients undergoing PD.