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Deficiencia de carnitina inducida durante la hemodiálisis intermitente para la insuficiencia renal
Lancet (London, England)
|January 21, 1978
Resumen
La hemodiálisis reduce significativamente los niveles de carnitina en pacientes con insuficiencia renal, lo que lleva al agotamiento muscular. Esta deficiencia de carnitina puede explicar las complicaciones cardíacas en pacientes con diálisis a largo plazo.
Área de la Ciencia:
- Nefrología Nefrología.
- La bioquímica es la bioquímica.
- Cardiología Cardiología.
Sus antecedentes:
- La carnitina es esencial para el metabolismo energético celular.
- La insuficiencia renal y la hemodiálisis pueden alterar la homeostasis de la carnitina.
- La disfunción cardíaca es una complicación conocida en pacientes en diálisis a largo plazo.
Objetivo del estudio:
- Para cuantificar los niveles de carnitina en plasma y músculo antes y después de la hemodiálisis.
- Para evaluar la pérdida de carnitina en el dializado.
- Investigar el vínculo entre la deficiencia de carnitina y los problemas cardíacos en pacientes con insuficiencia renal.
Principales métodos:
- Medición de las concentraciones de carnitina en el plasma, el músculo y el dializado.
- Comparación de los niveles de carnitina entre pacientes con insuficiencia renal sometidos a hemodiálisis y controles sanos.
- Análisis de la pérdida de carnitina durante el tratamiento de hemodiálisis.
Principales resultados:
- Las concentraciones de carnitina muscular en 8/9 pacientes fueron del 10% de los niveles de control después de la hemodiálisis.
- Los niveles plasmáticos de carnitina disminuyeron significativamente después de la hemodiálisis en todos los pacientes.
- La pérdida de carnitina en el dializado excedió la pérdida urinaria normal, con una compensación incompleta.
Conclusiones:
- La hemodiálisis causa un agotamiento sustancial de la carnitina en pacientes con insuficiencia renal.
- En algunos pacientes puede ocurrir un deterioro de la absorción de carnitina muscular.
- La reducción de la carnitina probablemente contribuye a la cardiomiopatía y la insuficiencia cardíaca en pacientes con diálisis a largo plazo.
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