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Carnitine status of pediatric patients on continuous ambulatory peritoneal dialysis
1Department of Pediatric Nephrology, Children's Mercy Hospital, Kansas City, Mo.
Insights
Oral L-carnitine supplementation did not resolve high triglyceride levels in pediatric patients on continuous ambulatory peritoneal dialysis (CAPD). Plasma carnitine levels increased, but serum triglycerides remained elevated in both supplemented and unsupplemented groups.
Area of Science:
- Nephrology
- Biochemistry
- Pediatrics
Background:
- Pediatric patients on continuous ambulatory peritoneal dialysis (CAPD) may have altered carnitine metabolism.
- Hypertriglyceridemia is a common complication in patients undergoing dialysis.
Purpose of the Study:
- To investigate plasma carnitine levels in pediatric CAPD patients.
- To evaluate the efficacy of oral L-carnitine supplementation in treating hypertriglyceridemia in this population.
Main Methods:
- A randomized study involving 12 pediatric CAPD patients.
- Group 2 received oral L-carnitine (100 mg/kg/day) for 2 months; Group 1 did not.
- Plasma carnitine and serum triglyceride levels were measured at baseline and after 2 months.
Main Results:
- Baseline plasma carnitine levels were normal and similar between groups and a control population.
- Oral L-carnitine supplementation significantly increased plasma carnitine levels in Group 2.
- No significant changes in serum triglyceride levels were observed in either group after supplementation.
Conclusions:
- Pediatric patients on CAPD have normal plasma carnitine status.
- Oral L-carnitine supplementation is ineffective in resolving hypertriglyceridemia in pediatric CAPD patients.
Abstract:
Plasma carnitine and the effect of oral carnitine supplementation on serum triglycerides was studied in 12 pediatric patients receiving continuous ambulatory peritoneal dialysis (CAPD). Baseline evaluation of all patients included plasma carnitine and serum triglyceride values. Following randomization into two groups, only group 2 patients received oral L-carnitine supplementation, 100 mg/kg/day, for 2 months. The initial laboratory evaluation was repeated at the conclusion of the study. Plasma carnitine values were also determined from a control population. Mean baseline plasma carnitine concentrations of group 1 (39.8 +/- 8.0 nmol/ml) and group 2 (45.2 +/- 10.3 nmol/ml) patients were not significantly different from each other or from the control population. Serum triglyceride values were elevated in both groups (group 1 - 206.5 +/- 100.0 mg/dl; group 2 - 279.3 +/- 74.5 mg/dl). After 2 months, the mean plasma carnitine concentration of group 2 patients increased to 147.7 +/- 84.1 nmol/ml, significantly greater than the value of group 1, 32.8 +/- 8.0 nmol/ml (p less than 0.004). However, no significant change in the serum triglyceride level was noted in either group. We conclude that the plasma carnitine status of pediatric patients receiving CAPD is normal and that oral carnitine supplementation does not lead to the resolution of hypertriglyceridemia.