Carnitine (C) plays an important role in lipid metabolism, being essential for the optimal oxidation of free fatty acids. Deficiency of C (MW 168), secondary to losses in dialysis effluents, has been described in patients undergoing HD. Attempts to correct hypertriglycer idemia by adding intravenous or oral L-Carnitine have given variable results. We studied the effects of adding L-Carnitine to dialysate fluid (2 g/dialysis x 4 weeks) on serum triglycerides (TG), free fatty acids (FFA), free carnitine (FC) and total carnitine (TC) In 10 patients (x: age 18 yrs; range 9-21) undergoing chronic HD, Results (x ± SD) were:

These data suggest: a) children on HD have slgnificantly decreased FC and increased TG; h) carnitine losses can he replaced by adding L-Carnitine into dialysis fluid; c) significant increase in FC and TC with a concommitant decrease in TG (average 28%) occurs after four weeks of L-Carnitine supplementation. This reflects a better oxidation of FFA wi th the resultant decreased synthesis of TG. Long term beneficial effects of L-Carnitine supplementation on dialysis hyperlipidemia deserves further evaluation.

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