[Secondary L-carnitine deficiency in chronic hemodialysis patients]

L-carnitine is an essential substance for the decomposition of long-chain fatty acids and thus for the obtaining of energy in the mitochondria. The L-carnitine fractions in the serum were analysed in 10 patients undergoing haemodialysis before and after the dialysis treatment. 4 patients received a substitution of L-carnitine by oral application of 3.0 and 1.0 g, respectively, after every dialysis or as addition to the dialysate (ca. 62 mumol/l) for in each case 4 weeks. In patients undergoing dialysis the serum carnitine fractions were in many cases already clearly diminished before the dialysis. During the treatment the total L-carnitine levels decreased by ca. 50%, the free L-carnitine values by ca. 70%. Particularly distinct carnitine depletions were found in patients with catabolic metabolic condition, incompatibility of dialysis and post-dialysis syndrome. All forms of application and dosages chosen led to a good correction of the serum carnitine concentrations. 2 patients with oral L-carnitine substitution of 3.0 g and resulting from this serum carnitine levels highly significantly lying above the normal region mentioned ameliorations of the subjective lipid parameters cholesterol, HDL-cholesterol and triglycerides could not be changed in the short period of observation by substitution of L-carnitine.