Evaluation of carnitine levels according to the peritoneal equilibration test in patients on continuous ambulatory peritoneal dialysis.

The evidence of carnitine abnormal metabolism in patients on continuous ambulatory peritoneal dialysis (CAPD) is unclear, and previous studies have reported conflicting results. The total (TC), free (FC), and acylated (AC) carnitines were estimated in blood and dialysate, as well as the AC/FC ratio, in 29 patients on CAPD, grouped into high (H-Abs) and low (L-Abs) absorbers, according to the results of the peritoneal equilibration test (fast PE-test). Our data demonstrated that patients with higher peritoneal transport rates, which was the H-Abs group, males and females, showed a better carnitine metabolic status compared to the L-Abs group. Although the H-Abs group lost significantly more free carnitine than the L-Abs group, the AC/FC ratio of the H-Abs group remained within normal range. All the patients in our study showed abnormally high triglyceride (TRG) levels and an abnormally high total cholesterol/HDL cholesterol ratio. In particular, the patients in the L-Abs group showed significantly higher TRG levels and total cholesterol/HDL cholesterol ratios than the H-Abs group. Those patients who have been on CAPD for more than 2 years showed significantly abnormally higher AC/FC ratios than those with shorter periods on CAPD treatment. In patients with AC/FC ratio greater than 0.4, the supplementation of L-carnitine may have a beneficial effect on their carnitine and lipid metabolism.