Alteration of energy production by the heart in CRF patients undergoing peritoneal dialysis

Ogimoto, Goichi; Sakurada, Tsutomu; Imamura, Keiko; Kuboshima, Shingo; Maeba, Teruhiko; Kimura, Kenjiro; Owada, Shigeru

doi:10.1007/978-1-4615-0247-0_20

Cited by 2 publications

(2 citation statements)

References 17 publications

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“…These observations are supported by clinical studies of patients on peritoneal dialysis, with a negative correlation between phosphocreatine/ ATP ratio and dialysis duration (7). As cardiac ATP production is tightly linked to substrate metabolism, one potential mechanism for the impaired energetics may be through alterations in the profile of energy provision.…”

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confidence: 68%

Myocardial Function, Energy Provision, and Carnitine Deficiency in Experimental Uremia

Reddy

Bhandari

Seymour

2007

Journal of the American Society of Nephrology

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Cardiac complications are the leading cause of mortality in patients with chronic renal failure. Secondary carnitine deficiency, which is frequently observed in hemodialysis patients, has been associated with cardiac hypertrophy and heart failure and may impair myocardial fatty acid oxidation. In chronic kidney disease, impaired carnitine homeostasis also may affect myocardial metabolism. In this study, myocardial function and substrate oxidation in conjunction with carnitine deficiency were investigated in experimental renal failure. Uremia was induced in male Sprague-Dawley rats via a two-stage five-sixths nephrectomy. Cardiac function and substrate oxidation were assessed in vitro by means of isovolumic perfusion using 13 C nuclear magnetic resonance at 3 and 6 wk of uremia. Renal impairment as assessed by serum creatinine was more severe initially and was associated with a significant deficiency in serum free carnitine (43%; P < 0.001) and elevated acyl carnitine/free carnitine ratio. Myocardial tissue carnitine concentrations, however, were unaffected. A moderate degree of cardiac hypertrophy (10 to 14%; P < 0.05) was observed in uremia without evidence of dysfunction or changes in myocardial substrate utilization. It is concluded that renal dysfunction is associated with cardiac hypertrophy in the presence of normal myocardial carnitine levels, despite a significant depletion in serum carnitine. This may be a factor in maintaining normal cardiac function and metabolism.

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confidence: 68%

Myocardial Function, Energy Provision, and Carnitine Deficiency in Experimental Uremia

Reddy

Bhandari

Seymour

2007

Journal of the American Society of Nephrology

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“…This is supported by the fact that skeletal muscle biopsies in CKD showed significantly low ATP and phosphocreatine levels [ 23 ]. This notion is further supported by studies showing lower phosphocreatine concentrations and a decreased phosphocreatine/ATP energy-charge ratio in the hearts and skeletal muscle of patients on either hemodialysis or peritoneal dialysis treatment, as shown by means of non-invasive in vivo 31P-NMR imaging [ 24 , 25 , 26 ].…”

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confidence: 83%

Chronic Dialysis Patients Are Depleted of Creatine: Review and Rationale for Intradialytic Creatine Supplementation

et al. 2021

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There is great need for the identification of new, potentially modifiable risk factors for the poor health-related quality of life (HRQoL) and of the excess risk of mortality in dialysis-dependent chronic kidney disease patients. Creatine is an essential contributor to cellular energy homeostasis, yet, on a daily basis, 1.6–1.7% of the total creatine pool is non-enzymatically degraded to creatinine and subsequently lost via urinary excretion, thereby necessitating a continuous supply of new creatine in order to remain in steady-state. Because of an insufficient ability to synthesize creatine, unopposed losses to the dialysis fluid, and insufficient intake due to dietary recommendations that are increasingly steered towards more plant-based diets, hemodialysis patients are prone to creatine deficiency, and may benefit from creatine supplementation. To avoid problems with compliance and fluid balance, and, furthermore, to prevent intradialytic losses of creatine to the dialysate, we aim to investigate the potential of intradialytic creatine supplementation in improving outcomes. Given the known physiological effects of creatine, intradialytic creatine supplementation may help to maintain creatine homeostasis among dialysis-dependent chronic kidney disease patients, and consequently improve muscle status, nutritional status, neurocognitive status, HRQoL. Additionally, we describe the rationale and design for a block-randomized, double-blind, placebo-controlled pilot study. The aim of the pilot study is to explore the creatine uptake in the circulation and tissues following different creatine supplementation dosages.

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Alteration of energy production by the heart in CRF patients undergoing peritoneal dialysis

Cited by 2 publications

References 17 publications

Myocardial Function, Energy Provision, and Carnitine Deficiency in Experimental Uremia

Myocardial Function, Energy Provision, and Carnitine Deficiency in Experimental Uremia

Chronic Dialysis Patients Are Depleted of Creatine: Review and Rationale for Intradialytic Creatine Supplementation

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