Related Experiment Video
Updated: Apr 5, 2026
08:50
5/6th Nephrectomy in Combination with High Salt Diet and Nitric Oxide Synthase Inhibition to Induce Chronic Kidney Disease in the Lewis Rat
Published on: July 3, 2013
24.5K
Carnitine deficiency in children receiving continuous renal replacement therapy
Kristen Sgambat1, Asha Moudgil1
1Department of Nephrology, Children's National Health System, Washington, DC, USA.
Hemodialysis International. International Symposium on Home Hemodialysis
|August 13, 2015
Summary
Continuous renal replacement therapy (CRRT) rapidly depletes carnitine levels in children, leading to deficiency. This carnitine deficiency is linked to a higher risk of death in pediatric patients undergoing CRRT.
Area of Science:
- Pediatric Nephrology
- Critical Care Medicine
- Nutritional Science
Background:
- Carnitine deficiency is a known complication of chronic hemodialysis.
- The impact of continuous renal replacement therapy (CRRT) on carnitine homeostasis in children remains unstudied.
- Children on CRRT may be at risk due to removal, poor intake, reduced production, and critical illness comorbidities.
Purpose of the Study:
- To investigate the effect of CRRT on carnitine levels in pediatric patients.
- To determine the prevalence of carnitine deficiency during CRRT.
- To assess the relationship between carnitine deficiency and mortality in this population.
Main Methods:
- Retrospective review of pediatric patients receiving CRRT for acute kidney injury.
- Measurement of total carnitine (TC) and free carnitine (FC) levels at baseline and during CRRT.
- Statistical analysis including chi-square, Pearson's correlation, and logistic regression.
Main Results:
- 30.7% and 35.7% of patients were TC and FC deficient at baseline.
- Carnitine deficiency prevalence increased significantly within weeks of CRRT initiation, reaching 100% by 3 weeks.
- TC and FC levels negatively correlated with duration on CRRT, and deficiency was associated with increased mortality risk (5.9x for TC, 4.9x for FC).
Conclusions:
- CRRT leads to rapid and significant carnitine depletion in pediatric patients.
- Carnitine deficiency during CRRT is associated with increased mortality.
- Further research into the consequences of carnitine deficiency and the benefits of supplementation in this population is warranted.
Related Concept Videos
01:30Continuous Renal Replacement Therapy
2.0K
Continuous Renal Replacement Therapy, also known as CRRT, is a procedural treatment for acute kidney injury (AKI) that gradually removes uremic toxins and fluids while maintaining acid-base balance and stabilizing electrolytes. It is particularly useful for hemodynamically unstable patients. Unlike intermittent hemodialysis, which is faster, CRRT provides a gentler approach over 24 hours, closely mimicking the function of natural kidneys. However, CRRT is not ideal for patients with...
2.0K
01:26Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy
354
Continuous Renal Replacement Therapy (CRRT) is an essential intervention for patients experiencing severe kidney dysfunction. This therapy offers a continuous mechanism for removing fluids and toxins from the bloodstream, leveraging the patient’s blood pressure to facilitate filtration through a specialized filter. This method contrasts with intermittent dialysis, providing a gentler and more consistent removal of waste products and excess fluid, which is particularly beneficial in...
354
01:28Chronic Kidney Disease III: Interprofessional Care
627
Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
627
01:11Renal Failure: Dose Adjustments
588
In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
588
01:20Acute Kidney Injury V: Interprofessional Care
481
Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
481
01:24Chronic Kidney Disease II: Clinical Manifestations
970
Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
970