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Carnitine metabolism in renal disease and dialysis

Author
Alan Wasserstein, MD
Section Editor
Steve J Schwab, MD
Deputy Editor
Alice M Sheridan, MD

INTRODUCTION

Carnitine deficiency may be a significant problem in patients with kidney disease, particularly in those undergoing maintenance dialysis. A discussion of carnitine metabolism, as well as the role of carnitine supplementation in this patient population, is presented in this topic review.

ROLE OF CARNITINE IN INTERMEDIARY METABOLISM

Carnitine is an important intermediary in fat metabolism. It is required to shuttle long-chain fatty acids, in the form of acylcarnitines, into mitochondria for beta-oxidation; carnitine is, therefore, crucial for energy production in tissues dependent upon fatty acid oxidation, such as cardiac and skeletal muscle.

Reactions of carnitine with activated fatty acids (acyl CoA) are esterifications of the general form:

acyl CoA + carnitine -> acylcarnitine + CoASH

and are catalyzed by a family of carnitine acyltransferases.

                   

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Literature review current through: Nov 2016. | This topic last updated: Wed Oct 14 00:00:00 GMT+00:00 2015.
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