血液透析患者肉碱缺乏症和肉碱水平降低的患病率。
Prevalence of Carnitine Deficiency and Decreased Carnitine Levels in Patients on Hemodialysis.
机构信息
Division of Nephrology, Hypertension and Endocrinology, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan.
Department of Nephrology, Keiai Hospital, Tokyo, Japan.
出版信息
Blood Purif. 2019;47 Suppl 2:38-44. doi: 10.1159/000496720. Epub 2019 Apr 3.
BACKGROUND
Patients on hemodialysis (HD) are known to be at risk of carnitine deficiency. The aims of this study were to investigate the prevalence of carnitine deficiency in patients on dialysis and to compare the likelihood of a reduction in the serum carnitine level on HD with that on hemodiafiltration (HDF).
METHODS
The prevalence of carnitine deficiency, defined as a serum free carnitine level < 20 μmol/L, and that of carnitine insufficiency, defined as an acyl/free carnitine ratio > 0.4, was investigated in 150 patients on dialysis. The reduction rate of serum carnitine was then compared between HD and HDF.
RESULTS
The prevalence of carnitine deficiency and that of carnitine insufficiency was 25.3 and 86.7%, respectively. Patients at high risk of carnitine deficiency accounted for 64.7%. Multivariate regression identified an association of duration of dialysis with the free serum carnitine level. The reduction rates of serum free carnitine in HD and HDF were 64 ± 4 and 75 ± 7%, respectively (p < 0.0001).
CONCLUSION
The prevalence rates of carnitine deficiency and carnitine insufficiency were high in patients on dialysis. The serum carnitine reduction rate was greater with HDF than with HD.
背景
血液透析（HD）患者已知存在肉碱缺乏的风险。本研究旨在调查透析患者肉碱缺乏的患病率，并比较血液透析滤过（HDF）与血液透析（HD）降低血清肉碱水平的可能性。
方法
调查了 150 名透析患者的肉碱缺乏症患病率（定义为血清游离肉碱水平 < 20 μmol/L）和肉碱不足症患病率（定义为酰基/游离肉碱比 > 0.4）。然后比较了 HD 和 HDF 之间血清肉碱的降低率。
结果
肉碱缺乏症和肉碱不足症的患病率分别为 25.3%和 86.7%。肉碱缺乏高风险患者占 64.7%。多变量回归分析发现透析时间与游离血清肉碱水平相关。HD 和 HDF 中血清游离肉碱的降低率分别为 64 ± 4%和 75 ± 7%（p < 0.0001）。
结论
透析患者肉碱缺乏症和肉碱不足症的患病率较高。HDF 比 HD 降低血清肉碱的速度更快。
Zotero 插件