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Are low birth weight children predisposed to renal loss of carnitine?

Piotr Tomasz Protas1, Alina Kępka2, Agnieszka Rybi-Szuminska1

  • 1Department of Pediatrics and Nephrology, Medical University of Białystok, Białystok, Poland.

The Journal of Maternal-Fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
|December 5, 2018
PubMed

Insights

Low birth weight infants show higher urinary excretion of l-carnitine (LC) and acetyl-carnitine (ALC), suggesting potential renal dysfunction. This increased excretion negatively correlates with birth weight and estimated glomerular filtration rate (eGFR).

Area of Science:

  • Pediatric Nephrology
  • Biochemistry
  • Neonatology

Background:

  • Plasma carnitine homeostasis is primarily regulated by renal tubular reabsorption.
  • Renal function and carnitine metabolism may be compromised in low birth weight (LBW) infants.
  • Disturbances in carnitine excretion could indicate underlying renal dysfunction in LBW neonates.

Purpose of the Study:

  • To investigate whether altered excretion of l-carnitine (LC) and acetyl-carnitine (ALC) in low birth weight (LBW) children is associated with renal dysfunction.
  • To assess the relationship between birth weight, renal function (eGFR), and urinary carnitine levels in LBW infants.

Main Methods:

  • A comparative study involving 59 LBW infants and 22 normal birth weight infants.
  • Urine samples were collected and analyzed spectrophotometrically for free and esterified carnitine levels.
  • Subjects were categorized into three age groups: 0-3 months, 4-12 months, and over 1 year.

Main Results:

  • LBW infants exhibited significantly higher urinary excretion of free LC, total LC, and ALC compared to controls across all age groups.
  • A significant negative correlation was observed between birth weight and urinary levels of free LC/cr, total LC/cr, and ALC/cr.
  • In children over 12 months, a strong negative correlation was found between estimated glomerular filtration rate (eGFR) and urinary free LC/cr, total LC/cr, and ALC/cr.

Conclusions:

  • Elevated urinary excretion of LC and ALC in LBW infants suggests potential renal tubular dysfunction.
  • The negative correlation between carnitine excretion, birth weight, and eGFR supports the hypothesis of impaired renal handling of carnitines in LBW infants.
  • These findings highlight the need for monitoring renal function in LBW infants due to altered carnitine metabolism.

Keywords:
Carnitinelow birth weighturine

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