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• W3021907586 abstract "We would like to thank the authors for their comments regarding our recently published paper1.Evans A.M. Faull R.J. Nation R.L. et al.Impact of hemodialysis on endogenous plasma and muscle carnitine levels in patients with end-stage renal disease.Kidney Int. 2004; 66: 1527-1534Abstract Full Text Full Text PDF PubMed Scopus (49) Google Scholar. While we recognize that alterations in the enzymatic activity of CAT, CPT, and OCTN2 may account, at least in part, for the accumulation of acylcarnitines in chronic hemodialysis patients, recent research by our group has suggested an alternative cause for the changes in carnitine pool composition in this population. A number of studies have investigated the impact of a single hemodialysis session on acylcarnitine levels in hemodialysis patients2.Penn D. Schmidt-Sommerfeld E. Carnitine and carnitine esters in plasma and adipose tissue of chronic uremic patients undergoing hemodialysis.Metabolism. 1983; 32: 806-809Abstract Full Text PDF PubMed Scopus (37) Google Scholar,3.Wanner C. Förstner-Wanner S. Rössle C. et al.Carnitine metabolism in patients with chronic renal failure: Effect of L-carnitine supplementation.Kidney Int. 1987; 32: S132-S135Google Scholar. These studies demonstrated a significantly higher acylcarnitine to L-carnitine ratio in postdialysis plasma samples compared to predialysis levels, indicating a larger loss of L-carnitine than acylcarnitines into the dialysate. A recent study by our group investigated the impact of a dialysis session on individual endogenous acylcarnitine levels in chronic hemodialysis patients4.Reuter S.E. Evans A.M. Faull R.J. et al.Impact of haemodialysis on individual endogenous plasma acylcarnitine levels in end-stage renal disease.Ann Clin Biochem. in press. 2005Google Scholar. The study examined pre- and postdialysis plasma concentrations of L-carnitine and 31 individual acylcarnitines in 50 patients. We demonstrated that 29 out of the 31 acylcarnitines were significantly elevated in the ESRD population when compared to healthy controls. For carnitine esters with an acyl-chain length less than 8 carbons, plasma acylcarnitine levels decreased significantly over the course of the dialysis session; however, levels invariably remained higher than those observed in the healthy population. Once acylcarnitine carbon-chain length exceeded 8 carbons, the dialytic removal of these compounds diminished, with a significant correlation between carbon-chain length and dialytic removal Figure 1. In light of these findings, we propose that, in combination with disturbed metabolism, the observed alterations in the carnitine pool are contributed to by a decrease in the dialytic removal of acylcarnitines, in particular long-chain acylcarnitines, most likely a result of the increased molecular weight and lipophilicity that accompanies increased chain length." @default.
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• W3021907586 date "2005-09-01" @default.
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• W3021907586 title "Reply from the Authors" @default.
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• W3021907586 doi "https://doi.org/10.1038/ki.2005.4496223" @default.
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