Author/Authors :
Naseri, Mitra Department of Pediatric Nephrology - Dr Sheikh Children Hospital - Mashhad University of Medical Sciences, Mashhad, Iran , Mottaghi Moghadam Shahri, Hasan Department of Pediatric Cardiology - Imam Reza Hospital - Mashhad University of Medical Sciences, Mashhad, Iran , Horri, Mohsen Department of Pediatric Cardiology - Imam Reza Hospital - Mashhad University of Medical Sciences, Mashhad, Iran , Esmaeeli, Mohammad Department of Pediatric Nephrology - Dr Sheikh Children Hospital - Mashhad University of Medical Sciences, Mashhad, Iran , Ghaneh Sherbaf, Fatemeh Department of Pediatric Nephrology - Dr Sheikh Children Hospital - Mashhad University of Medical Sciences, Mashhad, Iran , Jahanshahi, Shohre Hemodialysis Unit - Dr Sheikh Children Hospital - Mashhad University of Medical Sciences, Mashhad, Iran , Moeenolroayaa, Giti Hemodialysis Unit - Dr Sheikh Children Hospital - Mashhad University of Medical Sciences, Mashhad, Iran , Rasoli, Zahra Hemodialysis Unit - Dr Sheikh Children Hospital - Mashhad University of Medical Sciences, Mashhad, Iran , Salemian, Farzaneh Peritoneal Dialysis Unit - Dr Sheikh Children Hospital - Mashhad University of Medical Sciences, Mashhad, Iran , Pour Hasan, Maryam Hemodialysis Unit - Dr Sheikh Children Hospital - Mashhad University of Medical Sciences, Mashhad, Iran
Abstract :
Introduction. Carnitine deficiency is commonly seen in dialysis
patients. This study assessed the association dialysis and pediatric
patients’ characteristics with plasma carnitines levels.
Materials and Methods. Plasma carnitine concentrations were
measured by tandem mass spectrometry in 46 children on
hemodialysis or peritoneal dialysis. The total carnitine, free
carnitine (FC), and L-acyl carnitine (AC) levels of 40 μmol/L and
less, less than 7 μmol/L, and less than 15 μmol/L were defined
low, respectively. An FC less than 20 μmol/L and an AC/FC ratio
greater than 0.4 were considered as absolute and relative carnitine
deficiencies. The correlation between carnitines levels and AC/
FC ratio and age, duration of dialysis, characteristics of dialysis,
and blood urea nitrogen and serum albumin concentrations were
assessed.
Results. Absolute carnitine deficiency, low total carnitine, and
low AC concentrations were found in 66.7%, 82.6%, and 51% of
the patients, respectively. All of the patients had relative carnitine
deficiency. Carnitine measurements were not significantly different
between the hemodialysis and peritoneal dialysis groups. More
severe relative carnitine deficiency was found in those with lower
blood urea nitrogen levels and those on peritoneal dialysis. No
linear correlation was found between carnitine levels and age,
duration of dialysis, characteristics of dialysis, serum albumin
level, or blood urea nitrogen level.
Conclusions. Absolute and relative carnitine deficiencies are
common among children on dialysis. Patients with lower blood
urea nitrogen levels and peritoneal dialysis patients are more prone
to severe relative carnitine deficiency.
