You are here

ERİTROPOETÎN TEDAVİSİ ALAN ÇOCUK PERİTON DİYALİZİ HASTALARINDA KARNİTİN SUPPLEMANTASYONU'NUN ANEMİYE ETKİLERİ

CARNITINE AFFECTS ON ANEMIA IN PEDIATRIC PATIENTS ON PERITONEAL DIALYSIS TREATED WITH ERYTHROPOIETIN

Journal Name:

Publication Year:

Keywords (Original Language):

Abstract (2. Language): 
Therapy of the anemia is a serious problem in patients with chronic renal failure. Several reports on adult patients have shown that supplementation with L-carnitine can decrease the requirement for rhEPO. We investigated this subject in 20 children on peritoneal dialysis with a median age of 11.2 years. After obtaining baseline data, all children were supplemented with L-carnitine 50 mg/kg/day. At baseline, free carnitine levels were lower than that of controls, although total carnitine levels were similar. At the end of the study, total, free and acyl carnitine levels increased while there was no significant change in hemoglobin levels or iron parameters. In conclusion, we could not demonstrate any beneficial effect of supplementation with L-carnitine on hemoglobin or iron parameters in children on peritoneal dialysis.
Abstract (Original Language): 
Anemi, kronik böbrek yetmezliği olan hastalarda en önemli tedavi problemlerinden biridir. Erişkin hastalarda yapılan çalışmalar, karnitin suplemantasyonu ile rekombinant insan eritropoetinine (rhEPO) olan ihtiyacın azaltılabileceğini göstermiştir. Yaş ortalaması 11.2 olan ve periton diyalizi tedavisi gören 20 çocuk hastada bu konuyu araştırdık. Bazal verilerin alınmasından sonra hastalara 50 mg/kg/gün dozunda karnitin suplemantasy onuna başlandı. Bazal olarak, hasta ve kontrol gruplarının total karnitin düzeyleri her ne kadar farklı değildiyse de hasta grubunda serbest karnitin düzeyleri düşüktü. Çalışma peryodunun sonunda hastaların total, serbest ve acil karnitin düzeyleri yükselmişti. Buna karşılık, hemoglobin, hematokht veya demir parametrelerinde bir değişiklik olmadı. Sonuç olarak; periton diyalizi tedavisi gören çocuklarda karnitin suplemantasyonu' nun hemoglobin ve demir parametrelerine faydalı bir etkisini gözlemedik.
FULL TEXT (PDF): 
41-47

REFERENCES

References: 

1- Tong EM, Nissenson AR. Erythropoietin and anemia. Semin Nephrol 2001 ;21:190-203.
2- Bartel LL, Hussey JL, Shrago E. Perturbation of serum carnitine levels in human adults by chronic renal disease and dialysis therapy. Am J Clin Nutr 1981;34:1314-20.
3- Battistella PA, Angleini C, Vergani L, Bertoli M, Lorenzi S. Carnitine deficiency induced during haemodialysis. Lancet 1978; 1:939.
4- Guarnieri G, Toigo G, Crapesi L, et al Carnitine metabolism in chronic renal failure. Kidney Int Suppl 1987;22:S116-27.
5-
Albertazz
i A, Capelli P, Di Paolo B, Pola P, Tondi P, Vaccario O. Endocrine-metabolic effects of 1-camitine in patients on regular dialysis treatment. Proc Eur Dial
Transplant Assoc 1983;19:302-307.
6- Vacha GM, Giorcelli G, Siliprandi N, Corsi M. Favorable effects of L-camitine treatment on hypertriglyceridemia in hemodialysis patients: decisive role of low levels of high-density lipoprotein-
cholesterol. Am J Clin Nutr 1983;38:532-540.
7- Bellinghieri G, Savica V, Mallamace A, et al Correlation between increased serum and tissue L-carnitine levels and improved muscle symptoms in hemodialyzed patients. Am J Clin Nutr 1983;38:523-31.
8- Labonia WD, Morelli OH Jr, Gimenez MI, Freuler PV,
Morelli OH. Effects of L-carnitine on sodium transport in erythrocytes from dialyzed uremic patients. Kidney
Int 1987;32:754-9.
9- Labonia WD. L-carnitine effects on anemia in hemodialyzed patients treated with erythropoietin. Am
J Kidney Dis 1995;26:757-64.
10- Guarnieri G, Toigo G, Crapesi L, et all. Metabolism in chronic renal failure. Acute effects of carnitine addition to the dialysate during acetate hemodialysis. Contrib
Nephrol 1988;65:1-23.
11- Gloggler A, Bulla M, Furst P. Effect of low dose supplementation of L-carnitine on lipid metabolism in hemodialyzed children. Kidney Int Suppl 1989;27:S256-8.
12- Golper TA, Wolfson M, Ahmad S, et al. Multicenter
trial of L-carnitine in maintenance hemodialysis patients. I. Carnitine concentrations and lipid effects.
Kidney Int 1990;38:904-11.
13- Berard E, Iordache A. Effect of low doses of L-carnitine on the response to recombinant human erythropoietin in hemodialyzed children: About two
cases. Nephron 1992;62:368-9.
14- Lilien MR, Duran M, Quak JM, Frankhuisen JJ, Schroder CH. Oral L-carnitine does not decrease erythropoietin requirement in pediatric dialysis. Pediatr Nephrol 2000; 15 :1 7-20.
15- Boulat O, Janin B, Francioli P, Bachmann C. Plasma
carnitines: reference values in an ambulatory population. Eur J Clin Chem Clin Biochem 1993:31:585-9.
16- Cederblad G, Harper P, Lindgren K. Spectrophotometry of carnitine in biological fluids and tissue with a cobas bio centrifugal analyzer. Clin Chem 1986;32:342-6.
17- Bohmer T, Bergrem H, Eiklid K. Carnitine deficiency induced during intermittent haemodialysis for renal
failure Lancet. 1978;1:126-8.
18- Gloggler A, Bulla M, Puchstein C, Gulotta F, Furst P.
Plasma and muscle carnitine in healthy and hemodialyzed children. Child Nephrol Urol 1988-89;9:277-82.
19- Zachwieja J, Duran M, Joles JA, et al. Amino acid and carnitine supplementation in haemodialysed
children. Pediatr Nephrol 1994;8:739-43.
20- Warady BA, Borum P, Stall C, Millspaugh J,
Taggart E, Lum G. Carnitine status of pediatric patients on continuous ambulatory peritoneal
dialysis. Am J Nephrol 1990;10:109-14.
21- Murakami
R
, Momota T, et al. Serum carnitine and
nutritional status in children treated with continuous ambulatory peritoneal dialysis. J
Pediatr Gastroenterol Nutr 1990;11:371-4.
22- Constantin-Teodosiu D, Kirby DP, Short AH,
Burden RP, Morgan AG, Greenhaff PL. Free and esterified carnitine in continuous ambulatory peritoneal dialysis patients. Kidney Int
1996;49:158-62.
23- Pliakogiannis T, Chatzidimitriou C, Evangeliou A, Bohles HJ, Kalaitzidis K. Serum carnitine levels, lipid profile, and metabolic status of patients on continuous ambulatory peritoneal
dialysis. Perit Dial Int Suppl 1993;13:S440-3.
24- Kavadias D, Fourtounas C, Tsouchnikas J, Barboutis K. L-carnitine and erythropoietin requirements in hemodialysis patients. Am J
Kidney Dis 1996,28:156
25- Boran M, Dalva I, Gonenc F, Cetin S. Response to recombinant human erythropoietin (r-Hu EPO) and L-carnitine combination in patients with anemia of end-stage renal disease. Nephron
1996;73:314-5.
26- Kletzmayr J, Mayer G, Legenstein E, et al. Anemia and carnitine supplementation in hemodialyzed patients. Kidney Int Suppl
1999;69:S93-106.
27- Ahmad S, Bras EP, Hoppel C, et al. Role of L-
carnitine in treating renal dialysis patients. Dial
Transplant 1994;23:177-81.
28- Berard E, Barrillon D, Iordache A, Bayle J, Cassuto-Viguier E. Low dose of L-carnitine impairs membrane fragility of erythrocytes in hemodialysis patients. Nephron 1994;68:145.
29- Matsumura M, Hatakeyama S, Koni I, Mabuchi H, Muramoto H. Correlation between serum
46
carnitine levels and erythrocyte osmotic fragility in hemodialysis patients. Nephron 1996;72:574-8.
30- Arduini A, Rossi M, Mancinelli G, et al. Effect of L-carnitine and acetyl-L-carnitine on the human erythrocyte membrane stability and deformability.
Life Sci 1990;47:2395-400.
31- Feinfeld DA, Kurian P, Cheng JT, et al. Effect of oral L-carnitine on serum myoglobin in hemodialysis patients. Ren Fail 1996;18:91-6.
32- Kooistra MP, Struyvenberg A, Van Es A. The response to recombinant human erythropoietin in patients with the anemia of end-stage renal disease is correlated with serum carnitine levels.
Nephron 1991;57:127-8.

Thank you for copying data from http://www.arastirmax.com