Kinetics of Serum Carnitine Fractions in Patients with Chronic Kidney Disease Not on Dialysis

• YANO JUNKO

  Division of Nephrology, Department of Medicine, Kurume University School of Medicine

• ITO SAKUYA

  Division of Nephrology, Department of Medicine, Kurume University School of Medicine

• KODAMA GOH

  Division of Nephrology, Department of Medicine, Kurume University School of Medicine

• NAKAYAMA YOSUKE

  Division of Nephrology, Department of Medicine, Kurume University School of Medicine

• KAIDA YUSUKE

  Division of Nephrology, Department of Medicine, Kurume University School of Medicine

• YOKOTA YUNOSUKE

  Division of Nephrology, Department of Medicine, Kurume University School of Medicine

• KINOSHITA YUKIE

  Research Institute of Medical Mass Spectrometry, Kurume University School of Medicine

• TASHIRO KYOKO

  Research Institute of Medical Mass Spectrometry, Kurume University School of Medicine

• FUKAMI KEI

  Division of Nephrology, Department of Medicine, Kurume University School of Medicine

Abstract

Summary: Background: Carnitine plays a pivotal role in energy synthesis through β-oxidation in mitochondria. Serum and tissue levels of free carnitine are significantly decreased in dialysis patients, whereas acylcarnitine levels are increased. However, the precise kinetics and fate of carnitine fractions in chronic kidney disease (CKD) patients who are not on dialysis have not been clarified. This study aims to determine the kinetics of serum carnitine fractions in patients who were not on dialysis. Methods: Seventy-five CKD patients not on dialysis were recruited in this study. Serum and urinary carnitine fraction levels were measured to evaluate the kinetics and regulation of serum carnitine fractions. Carnitine fractions were measured by the enzymatic cycling method. Results: Total and free serum carnitine levels did not change with progression of CKD, whereas acylcarnitine levels and the acyl/free carnitine ratio significantly increased. Serum acylcarnitine levels were inversely associated with estimated glomerular filtration rate (r² = 0.239, p < 0.001), but free carnitine levels were not. Serum free carnitine levels were positively associated with urinary free carnitine excretion (r² = 0.214, p < 0.001), but serum acylcarnitine levels were not. Multiple stepwise regression analysis revealed that urinary free carnitine excretion and blood urea nitrogen were independent determinants of serum free carnitine and acylcarnitine levels, respectively. Conclusions: The present study demonstrated that serum acylcarnitine levels increased with renal dysfunction independent of urinary excretion levels. Serum free carnitine was not affected by renal function in CKD patients who were not on dialysis.

Journal

• The Kurume Medical Journal

  The Kurume Medical Journal 66 (3), 153-160, 2019-09-30

  Kurume University School of Medicine

Keywords

• free carnitine
• acylcarnitine
• CKD
• renal excretion

Details

• CRID: 1390852581592858112
• NII Article ID: 130008101716
• DOI: 10.2739/kurumemedj.ms663001
• ISSN: 18812090
• ISSN: 00235679
• PubMed: 32848104
• Web Site: https://www.jstage.jst.go.jp/article/kurumemedj/66/3/66_MS663001/_pdf
• Text Lang: en
• Data Source:
  • JaLC
  • Crossref
  • PubMed
  • CiNii Articles
  • KAKEN
• Abstract License Flag: Disallowed