Buradasınız

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:

Publication Year:

Keywords (Original Language):

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.
FULL TEXT (PDF): 

REFERENCES

References: 

Correlation between increased serum and tissue L-carnitine levels and improved muscle symptoms in hemodialyzed patients. Am J Clin Nutr 1983; 38: SIS-SSI
10. Sakurauchi Y, Matsumoto Y, Shinzato T et al. Effects of L-carnitin supplementation on muscular symptoms in hemodialyzed patients. Am J Kidney Dis 1998; 32: 258-264
11. Spagnoli LO, Palmieri G, Mauriello A et al. Morphometric evidence of the trophic effect of L-Carnitine on human Skeletal Muscle. Nephron 1990; 55:16-23
12. Siami G, Clinton ME, Mrak R, Griffis .1, Stone W.
Evaluation of the effects of intravenos L-Carnitine theraphy on function, structure and fatty acid metabolism of skeletal muscle in patients receiving chronic hemodialysis. Nephron 1991; 57: 306-313
13. Bajnok L, Kozlovszky B, Varja Antalffy J, Olvaszto S, Fülop Jr T. Technetium-99m sestamibi scintigraphy for the assesment of lower extermity ischaemia in peripheral arterial disease. Eur J Nucl Med 1994; 21: 1326-1332
14. Hoppel C.The physiologycal role of L-carnitine. L-Carnitine and it's role in medicine from function to therapy. Ferrari R, Dimorro S, Sherwood G. Academic press Ltd London 1992, pp 5-21
15. Wanner C, Förstner Wanner S, Rössle C, Furst P, Schollmeyer P, Hörl WH. Carnitine metabolism in
1. Thompson CH, Kemp G.I, Taylor DJ, Ledingham JGG,
Radda GK, Rajagopalan B. Effect of chronic uraemia on skeletal muscle metabolism in man. Nephrol Dial
Transplant 1993; 8: 218-222
2. Ritz E, Bunndschu HD, Massry SG. Uremic Myopathy.
In Textbook of Nephrology Massry SG, Glassock R.I. Williams & Wilkins Baltimore 1995 volume 2, pp 1474-1477
3. Van der Niepen P, Allein S, Verbeelen D. Muscle metabolism in uremia and the effect of amino acid
supplementation. Nephron 1998; 79: 387-389
4. Taborsky P, Sotornik I, Kaslikova J, Schück O, Hajek M, Horska A. 3IP Magnetic Resonance Spectroscopy investigation of skeletal muscle metabolism in uraemic
patients. Nephron 1993; 65: 222-226
5. Cleyne N, Esbjörnsson M, Jansson E, Joge-strant T, Lins L-E, Pehrsson SK. Effects of renal failure on
skeletal muscle. Nephron 1993; 63: 395-399
6. Boehm KA, Helms RA, Christensen ML, Storm MC. Carnitine: A review for the pharmacy clinician. Hosp
Pharm 1993;28:847-850
7. Gilbert EF. Carnitine deficiency. Pathology 1985; 17: 161-169
8. Guarnieri G, Toigo G, Crapesi L et al. Carnitine metabolism in chronic renal failure. Contr Nephrol 1988; 65: 1-23
9. Bellinghieri G, Savica V, Mallamace A et al.
patients with chronic renal failure: Effect of L-carnitine supplementation. Kidney tat 1987; 32(suppl.22): 132¬135
16. Bartel LL, Hussey JL, Shrago E. Effect of dialysis on serum carnitine, free fatty acids, and triglyceride levels in man and rat. Metabolism 1982; 31: 944-947
17. Maeda K, Shinzato T, Kobayakawa H. Effects of L-carnitinc administration on short-chain fatty acid (acetic acid) and Long-chain fatty acid metabolism during
hemodialysis. Nephron 1989; 51: 355-361
18. Fagher B, Thysell H. Nilsson-Ehle P et al. The effect of D, L-carnitine supplementation on muscle metabolism, neurapathy, cadiac and hepatic function in hemodialysis
patients. Acta Med Scand 1982; 212: 115-120
19. Sloan RS, Kastan B, Rice SI et al. Quality of life during
and between hemodialysis treatments: Role of L-carnitine supplementation. Am J Kidney Dis 1998; 32: 265-272
20. Kim SB, Chi HS, Park JS, Hong CD, Yang WS. Effect
of increasing serum albumin on plasma D-Dimer, von Willebrand Factor, and platelet aggregation in CAPD
Patients. Am J Kid Dis 1999; 33:312-317
21. Song IS, Yang WS, Kim SB, Lee JH, Kwon TW, Park JS. Association of plasma fibrinogen concentration with vascular access failure in hemodialysis patients.
Nephrol Dial Transplant 1999; 14: 137-141
22. Scholte HR, Busch HFM, Luyt-Houwen IEM,
186
Vaandrager-Verduin MHM,
Przyrembe
l H, Arts WFM. Defects in oxidative phosphorylation. Biochemical investigations in skeletal muscle and expression of the lesion in other cells. J Inher Metab Dis 1987; lO(suppl.l): 81-97
23. Thompson CH, Kemp GJ, Barnes PRJ et at. Uraemic muscle metabolism at rest and during exercise. Nephrol Dial Transplant 1994; 9: 1600-1605
24. Giovenali P, Fenocchio D, Montanari G et al. Selective trophic effect of L-carnitine in type I and II skeletal
muscle fibers. Kidney Int 1994; 46: 1616-1619
25. Cittanti C, Colamussi P, Giganti M et al.Technetium-99m sestamibi leg scintigraphy for non-invasive assesment of propionil-L-carnitine induced changes in skeletal muscle metabolism. Eur J Nucl Med 1997; 24: 762-766
26. Brevetti G, di Lisa F, Perna S et al. Carnitine-related alterations in patients with intermittent claudication.
Circulation 1996; 93: 1685-1689
27. Galper TA, Ahmad S. L-carnitine administration to hemodialysis patients: Has its time come? Seminars in
Dialysis 1992; 5: 94-98
187

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