Abstract
The relationship between serum carnitine levels and erythrocyte osmotic fragility was investigated in 26 chronic hemodialysis patients (10 males and 16 females, mean age: 57.3±13.5 years). Serum total-carnitine (TC), free-carnitine (FC) and acyl-carnitine (AC) levels were determined spectrophotometrically using a Cobas Bio centrifugal analyzer. Erythrocyte osmotic fragility was measured with a coil planet centrifuge. Serum TC levels were 39.9±13.4μmol/l (mean±SD), FC levels were 21.8±7.8μmol/l and AC levels were 18.0±9.6μmol/l. Serum FC levels in hemodialysis patients were lower and AC levels were higher than those in healthy subjects. The mean hemolysis end point (HEP) was 67.4±5.4 mOsM, the hemolysis maximum point (HMP) was 86.3±5.4 mOsM and the hemolysis start point (HSP) was 101.2±4.4 mOsM. Each hemolysis point in hemodialysis patients was elevated in comparison with normal range. No significant hemolysis point differences were seen between the rHuEPO-treated and non-treated groups. The maintenance rHuEPO dose (U/kg/week) correlated with serum TC (r=-0.54, p<0.05) and FC levels (r=-0.50, p<0.05). HEP correlated with serum TC (r=-0.56, p<0.01) and AC levels (r=-0.58, p<0.01). HMP correlated with serum TC (r=-0.42, p<0.05) and FC levels (r=-0.41, p<0.05). These data support the supposition that low serum carnitine levels accelerate erythrocyte osmotic fragility. Carnitine may participate in erythrocyte membrane metabolism and impact on the efficacy of rHuEPO in correcting renal anemia.
