Abstract: TH-PO0736
Plasma L-Carnitine Levels in Patients with AKI or ESKD Before and During CKRT
Session Information
- AKI: Critical Care, CKRT, Cardiorenal Syndromes, and Clinical Outcomes
October 22, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 102 AKI: Clinical, Outcomes, and Trials
Authors
- Smith, Amanda, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States
- Foulon, North, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States
- Budnick, Isadore, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States
- Carniglia, Giada, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States
- Park, Samel, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States
- Blaine, Rachel, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States
- Okamura, Kayo, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States
- He, Zhibin, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States
- Faubel, Sarah, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States
Background
L-carnitine plays a key role in mitochondrial energy production. CKRT is associated with L-carnitine deficiency which may cause complications such as skeletal muscle weakness and impaired cardiac contractility. The kinetics of L-carnitine clearance during CKRT have not been assessed and the timing of deficiency is uncertain.
Methods
Plasma and effluent levels of L-carnitine were determined in critically ill subjects with AKI (n=89) or ESKD (n=16) with ultra-high pressure liquid chromatography-mass spectrometry just prior to anticipated CKRT initiation and days 1, 2, and 3 of CKRT. To define normal values, plasma L-carnitine in 26 healthy controls without kidney disease was assessed.
Results
Plasma L-carnitine levels were significantly higher in AKI (P<0.001) and significantly lower in ESKD (p=0.003) prior to CKRT initiation versus controls. Plasma L-carnitine, BUN, and creatinine levels during CKRT for AKI and ESKD are shown in Figure 1. By day 3 of CKRT, the majority of patients with AKI had levels of L-carnitine below normal. Effluent levels of L-carnitine were similar to plasma levels with a sieving coefficient of ~ 1 on all days of CKRT, indicating highly effective clearance.
Conclusion
L-carnitine is efficiently cleared by CKRT resulting in levels that are below normal in the majority of patients by day 3 of CKRT. Future studies to assess L-carnitine supplementation and outcomes during CKRT are warranted.
Figure 1. Plasma levels of L-carnitine, BUN, and creatinine in AKI or ESKD patients prior to and during the first three days of CKRT. In patients with AKI, plasma levels of L-carnitine (A), BUN (B), and creatinine (C) significantly declined during CKRT. In patients with ESKD, levels of L-carnitine (D) remained low, while BUN (E) and creatinine (F) significantly declined during CKRT. Data for L-carnitine are presented as fold change relative to the median of the normal control (represented by the dashed line at "1"); all data are presented as median and interquartile range. Statistics via ANOVA with Holm-Sidak multiple comparison adjustment.
Funding
- Private Foundation Support