Carnitine status in children with chronic kidney disease
DOI:
https://doi.org/10.15574/PP.2019.79.20Keywords:
carnitine status, children, chronic kidney diseaseAbstract
Purpose — to study the metabolic basis of the progression of chronic kidney disease (CKD) in children based on a study of carnitine status, to identify potential candidate markers of CKD progression.Patients and methods. The concentration of acylcarnitines in dry blood spots was determined in 38 children with CKD 2–5 st. aged from 2 to 17 by liquid chromatography tandem mass spectrometry.
Results. Certain metabolic changes were diagnosed in children with CKD 2–5 st. A clear tendency to a decrease in the free carnitine (C0) level begins to be traced at 4 st. CKD in comparison with the values obtained in patients with CKD 2 st. (p<0.05), reaching a minimum in patients with CKD 5 st. (p<0.05). The dynamics of the acetylcarnitine C2 level was wave-like, increasing 1.7 times in patients with CKD 3 st. in comparison with CKD 2 st. (p<0.05), acquiring a tendency to decrease in patients with CKD 4–5 st. When assessing the ratio of acetylcarnitine to free carnitine, a clear increase was observed from 0.47 for CKD 2 st. up to 0.79 with CKD 3 st. and up to 1.05 with CKD 2–5 st. The most indicative was the dynamics of C5DC (glutarylcarnitine) and C6DC (3-methylglutaconylcarnitine), which showed a significant difference in values between all groups of patients, gradually increasing from CKD 2 st. and reaching maximum values in patients with end-stage renal disease.
Conclusions. The metabolic profiling of the carnitine status of the blood allows us to determine a significant relationship between the severity of kidney damage and the level of acylcarnitines in children with CKD. Situations allowing both overproduction and shortages and occurring at the system level have been identified. Potential candidates for CKD progression were identified: acylcarnitines — C5DC (glutarylcarnitine), C6DC (3-methylglutaconylcarnitine). The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of Kyiv City Children's Clinical Hospital No. 1. The informed consent of the patient was obtained for conducting the studies. No conflict of interest were declared by the authors.
No conflict of interest were declared by the authors.
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