Kinetics of carnitine concentration after switching from oral administration to intravenous injection in hemodialysis patients

Abstract

Carnitine has high dialyzability and is often deficient in dialysis patients. This deficiency is treated by either intravenous (IV) or oral supplementation of carnitine. In this study, the mode of carnitine administration was changed from oral to IV in 17 hemodialysis (HD) patients, and the treatment was discontinued after 1 year. We found that the levels of total carnitine (TC), free-carnitine (FC), and acyl-carnitine (AC) significantly increased after 3 months of switching to IV administration (p < .05). After discontinuation of carnitine administration, the TC, FC, and AC levels decreased before dialysis. The average FC value was maintained at the normal levels until 9 months, but fell below the normal values when measured at the 12th month of discontinuation. In conclusion, carnitine was maintained at significantly high levels despite the smaller dose by IV infusion as compared with that by oral administration. We therefore suggest that our results be considered while determining both the carnitine administration route and the administration period in dialysis patients under clinical settings.

Association between carnitine deficiency and the erythropoietin resistance index in patients undergoing peritoneal dialysis: a cross-sectional observational study

“…Additionally, the utility of using carnitine as an osmotic substance in PD fluid has been reported [53]. Furthermore, supplementation of carnitine by intravenous administration is more effective than oral carnitine intake in patients undergoing hemodialysis [54]. Another study showed that certain levels (80-199 lmol/L) of carnitine supplementation decreased clinical complications, such as hypotension and muscle cramps, during hemodialysis sessions compared with higher levels of free carnitine ( !…”

Carnitine for Body Composition in Hemodialysis Patients

“…Carnitine was administered by L-Cartin FF injection 1000mg to patients three times a week in an average with Levocarnitine, which is (R)-3-Hydroxy-4-trimethylammoniobutanoate [13]. It was registered as 22400AMX01482, which has been provided for the treatment for carnitine deficiency [4]. Note: Data represent the mean value and standard error of the mean (SEM), Intervention is the adminstration of Carnitine injection for six months, dif: difference between 0 mont and 6 month, *: significant difference between 0 month and 6 month (p<0.05), np: not significant between 0 month and 6 month.…”

“…Carnitine deficiency has been known in patients on Hemodialysis (HD). It has been reported that administration of carnitine may bring clinical effects, such as improving cardiac function, decreasing muscle symptoms with muscle spasm and increasing the response of EPO to anemia [4].…”