Carnitine deficiency in haemodialysed patients.

Free carnitine, acylcarnitine and total carnitine concentrations have been determined in the sera of chronic renal insufficiency patients undergoing regular haemodialysis treatment and in those of healthy controls. The most striking difference was found to be the high proportion of acylated carnitine (23.4 μmol/l) in the haemodialysed patients. Free carnitine and acylcarnitine levels were not completely restored between successive dialysis treatments, making levels measured immediately before the third weekly sessions significantly lower than those measured before the first session (p < 0.01). In patients monitored throughout 25 wk of treatment, there was an exponential decay of both total serum carnitine levels (Spearman's r = −0.993, p < 0.001) and free carnitine levels (Spearman's r = −0.972, p < 0.001). It is suggested that in the absence of exogenous supplies of carnitine, endogenous synthesis is unable to make up for losses due to dialysis treatment, and that carnitine deficiency consequently ensues.