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Part 7: Nutrition in PD |
Department of Nephrology,1 SRMC & RI, and Madras Medical Mission,2 Chennai, India
Correspondence to: G. Abraham, Department of Nephrology, SRMC&RI, Porur, Tamil Nadu, India. abraham_georgi{at}yahoo.com
Objective: In the present study, we aimed to determine
levels of free carnitine in hemodialysis (HD) and peritoneal dialysis (PD)
patients in India and to correlate carnitine deficiency with various clinical
parameters.
Methods: Patients on HD and PD at two tertiary care
centers were selected for the study. Baseline data were obtained, and a free
carnitine analysis was performed. Carnitine deficiency was defined as a free
carnitine level of less than 40 µmol/L.
Results: The total number of study patients was 96 (77
on HD, 19 on PD). In the PD group, the mean age was 56 years, with 26.3% of
the patients being vegan, 47.4% having diabetes, and 57.9% having a daily
urine output of <500 mL. The mean carnitine level in that group was 38.9
µmol/L, and 68.4% of the patients had a carnitine deficiency. A Pearson
correlation test failed to show any association of carnitine level with
parameters such as anemia, use of erythropoietin, non-vegetarian diet,
diabetes, and hypertension. In the HD group, the mean age was 45 years, with
22% of the patients being vegan, 23% having diabetes, and 45.5% having a daily
urine output of <500 mL. The mean carnitine level in the group was 38.2
µmol/L, and 64.3% of the patients had a carnitine deficiency. Residual
renal function and duration of dialysis were different in HD patients with and
without carnitine deficiency. Carnitine levels in the HD group correlated
positively and statistically significantly with the presence of diabetes and
hypertension.
Conclusion: This study is the first demonstration that
Indian dialysis patients have carnitine deficiency.
KEY WORDS: Carnitine deficiency; CAPD; hemodialysis; anemia; residual renal function.
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