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Nephrol Dial Transplant (1989) 4: 951-956
© 1989 European Renal Association-European Dialysis and Transplant Association

research-article

Carnitine and Carnitine Esters in Acute Renal Failure

C. Wanner1,, W. Riegel1, R. M. Schaefer2 and W. H. Hörl1

1Departments of Medicine and Divisions of Nephrology, University Hospitals of Freiburg FRG 2Departments of Medicine and Divisions of Nephrology, University Hospitals of Würzburg FRG

Correspondence and offprint requests to: Correspondence and offprint requests to: Dr C. Wanner, Medizinische Universitätsklinik, Hugstetterstr. 55, 7800 Freiburg i. Br., FRG

Plasma concentrations of carnitine and carnitine esters were determined in patients with multiple forms of acute renal failure with and without sepsis, and also before and after haemodialysis therapy. Total carnitine, free carnitine, short-chain and long-chain acylcarnitine values of both groups of acute renal failure patients were markedly elevated compared with healthy subjects and chronically uraemic patients undergoing regular haemodialysis treatment. Carnitine and carnitine esters did not differ between septic and non-septic patients before and after haemodialysis with dialysers made of cuprophane or polysulphone. Animal experiments with acutely uraemic rats were performed in order to determine whether the liver or the kidney may be responsible for elevated carnitine and carnitine esters in acute renal failure. Plasma and liver total carnitine, free carnitine, short-chain acylcarnitine and long-chain acylcarnitine were significantly elevated in sham-operated animals, and further in ureter ligated and bilateral nephrectomised rats. Skeletal muscle and heart muscle carnitine and carnitine esters remained the same as in sham-operated controls.

Our data demonstrate markedly increased liver carnitine synthesis and carnitine acylation in an acute uraemic rat model even after binephrectomy and 48-h food depletion and in the presence of elevated serum carnitine concentrations. Furthermore, from our clinical study we conclude that there is no need for carnitine supplementation in patients who developed acute renal failure in the postoperative and post-traumatic state under adequate nutrition even when requiring daily haemodialysis.

Keywords: Acute renal failure; Carnitine; Carnitine esters; Haemodialysis


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S. E. Reuter, R. J. Faull, E. Ranieri, and A. M. Evans
Endogenous plasma carnitine pool composition and response to erythropoietin treatment in chronic haemodialysis patients
Nephrol. Dial. Transplant., March 1, 2009; 24(3): 990 - 996.
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