Wanic-Kossowska M
Kliniki Nefrologii Instytutu Chorób Wewnetrznych AM im. K. Marcinkowskiego w Poznaniu.
Pol Arch Med Wewn. 1997 Jun;97(6):534-40.
In 25 patients with chronic renal failure treated by haemodialysis with acetate-37 mEq/l containing fluid, plasma free, total carnitine and acetate concentration before and after HD were assessed. The concentration of acetate was high-12 mmol/l in 4 patients in which carnitine concentration was low. In these patients the incidence of the so-called "dialysis intolerance" or "acetate intolerance" such as acute hypotension, nausea, vomiting and headache were increased. The correlation between the serum acetate level and carnitine level and the symptoms suggest that the acetate overload during acetate dialysis affects acetate metabolism and administration of L-carnitine decreases the amount of accumulated acyl-CoA in the cytosol, and consequently--the citrate cycle function increases and diminish the intolerance symptoms.
对25例接受含37 mEq/l醋酸盐液体血液透析治疗的慢性肾衰竭患者，评估了血液透析前后血浆游离肉碱、总肉碱及醋酸盐浓度。4例患者的醋酸盐浓度较高（达12 mmol/l），其肉碱浓度较低。在这些患者中，诸如急性低血压、恶心、呕吐及头痛等所谓“透析不耐受”或“醋酸盐不耐受”的发生率增加。血清醋酸盐水平与肉碱水平及症状之间的相关性表明，醋酸盐透析期间的醋酸盐过载影响醋酸盐代谢，而补充左旋肉碱可减少胞质溶胶中酰基辅酶A的蓄积量，从而使柠檬酸循环功能增强，并减轻不耐受症状。
