Effect of chronic renal hemodialysis on serum total, free and acyl carnitine concentrations in adult chronic pyelonephritis patients.

In the present study, serum total (TC), free (FC), and acyl (AC) carnitine levels were investigated in 20 healthy controls (13 males and 7 females) and 27 patients (10 males and 17 females) with chronic pyelonephritis (CPN) undergoing regular chronic hemodialysis (CHD). The results showed that CHD treatment in CPN patients displays significantly decreased serum L-carnitine levels. The mean predialysis serum TC, FC, and AC (48 +/- 8, 42 +/- 6.3 and 13 +/- 2.7 nmol/ml, respectively) were not significantly different from the mean healthy control serum TC, FC and AC (50 +/- 7.1, 46 +/- 6.1 and 10 +/- 2.1 nmol/ml, respectively) (p < 0.1). However, after CHD, a significant decrease in serum TC, FC and AC levels (21.2 +/- 4.2, 17.1 +/- 3.1 and 6.1 +/- 2.4 nmol/ml, respectively) was observed compared to the values in both predialysis (48 +/- 8, 42 +/- 6.3 and 13 +/- 2.7 nmol/ ml, respectively) and healthy controls (50 +/- 7.1, 46 +/- 6.1 and 10 +/- 2.1 nmol/ml, respectively), (p < 0.001). Serum TC, FC and AC levels of male (49 +/- 5.5, 44 +/- 6.1 and 9.5 +/- 2.1 nmol/ml, respectively) and female (47.8 +/- 6.2, 38.5 +/- 9.3 and 9.7 +/- 2.3 nmol/l, respectively) healthy controls, and male (45.6 +/- 6.7, 44.1 +/- 5.1 and 12.3 +/- 1.5 nmol/ml, respectively) and female (46 +/- 5.1, 39 +/- 5.7 and 11.7 +/- 2.2 nmol/ml, respectively) predialysis patients showed no significant difference (p < 0.1). However, after CHD, serum TC, FC and AC levels of male (22.5 +/- 2.7, 16.8 +/- 3.9 and 5.1 +/- 2.1 nmol/ml, respectively) and female (19.5 +/- 2.4, 15.2 +/- 1.41 and 5.7 +/- 2.7 nmol/ml, respectively) patients were significantly decreased, compared with predialysis values (p < 0.001). After CHD, the ratio of serum AC to FC (0.47 +/- 0.03) was significantly increased compared with both healthy controls (0.3 +/- 0.03) and predialysis patients (0.32 +/- 0.03) (p < 0.001 and p < 0.01, respectively). Comparatively, the ratio of serum AC to FC was increased significantly after CHD (males, 0.45 +/- 0.02 and females, 0.41 +/- 0.03) when compared with both gender healthy controls (males, 0.29 +/- 0.052 and females, 0.26 +/- 0.033) and both gender predialysis patients (males, 0.33 +/- 0.02 and females 0.28 +/- 0.01), (p < 0.001). A possible physiological consequence of this finding remains unclear.