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KISA VE UZUN SÜRELÎL-KARNÎTÎN TEDAVİSİNİN DİYALİZ HASTALARINDAKİ KAS METABOLİZMASINA ETKİLERİ

SHORT AND LONG TERM EFFECTS OF L-CARNITINE ON SKELETAL MUSCLE METABOLISM AND NUTRITIONAL STATUS IN DIALYZED PATIENTS

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 1999

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Disorders and deficiency of carnitine that occured in dialysed patients plays an important role in ureamic myopathy (UM). To investigate ofUM in early stage and effects of the L-carnitine on UM was aimed. 35 stable dialysis patients (17 hemadialysis, 18 continuous ambulatory peritoneal dialysis), age-matched 44 healty persons were studied. After blood samples had drownout, Tc'9" sesta MİBİ rest scintigraphy were performed in 20 healty and in 25 patients. L-carnitine was given 2g/day for 4 months then 20-25 mg/kg/3 days a week for following 12 months in all patients. At initial, heamoglobin, hematocrite, erythrocytes and albumin, transferrin values of the patients were found lower than those of the controls, then increased during the 16 months constantly. Plasma von Willebrand Factor and creatinine, phosphate, creatine phosphocinase in serum were found higher in patients thus, decreased at the end of the L-carnitine treatment, whereas mean flbrinogene value was unchanged. In patients group, both thight and calf Tc m MİBİ uptake were found lower than those of the controls group at initial. After first six months increased, but no change was observed in following six months. Thus, suggested that carnitine have an effect on UM independently.
Abstract (Original Language): 
Kas enerji üretiminde gerekli olan karnitin'in diyaliz hastalarında yetersizliği, üremik myopati (ÜM) gelişimine katılır. Karnitin 'in, klinik ve EMG bulgusu vermemiş erken evre ÜM üzerine etkisini araştırmak için 17 hemodiyaliz, 18 devamlı ayaktan periton diyaliz tedavisindeki yaş ort. 46.5±14 yıl olan 35 hasta ve yaş ort. 44.8±9 yıl olan 44 sağlıklı birey çalışmaya alındı. Hastalara 4 ay 2g/gün, izleyen 12 ay 20-25 mg/kg haftada üç gün L- karnitin tedavisi uygulandı. 20 sağlıklı, 25 hastada, Tc'm sesta MİBİ ile üst ve alt bacak kas istirahat perfüzyon sintigrafisi çekildi. Hastalarda 6., 12. ayda sintigrafi ve 4,6.,12.,16. ayda biyokimyasal incelemeler tekrarlandı. Kontrol gruptan düşük olan hasta hemoglobin, hematokrit, eritrosit, albumin, transferrin değerleri dört ay sonra yükseldi, 16 ay boyunca düzenli yükseldi. Plazmada; yüksek olan fibrinojen değişmezken von Willebrand Faktör ve serumda; kreatinin, kreatin fosfokinaz, fosfor 16 ay sonra düştü. Kontrol gruptan düşük olan uyluk ve bacak radyonüklid tutulumu ilk 6 ayda arttı, izleyen 6 ayda değişmedi. Hastalarımızda, dördüncü ayda gözlenen anemi, protein ve endoteldeki iyileşme 16 aya dek artarak sürerken sintigrafık tutulumun 6 aydan sonra artmaması karnitin'in ÜM'de bağımsız etki yaptığını düşündürmektedir.
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