Abstract
We have investigated the effect of acetate and bicarbonate haemodialysis (HD) on the levels of erythrocyte, whole blood and plasma total (TC), free (FC), short(SC), long-chain acyl (LC) and acyl (AC) carnitine as well as the ratio of AC to FC in 44 healthy subjects (23 men and 21 women) and 83 patients (42 men and 41 women) with chronic renal failure (CRF) undergoing regular chronic HD. 42 patients (21 men and 21 women) used acetate HD and the remainder (21 men and 20 women) used bicarbonate HD. The mean pre-dialysis erythrocyte, whole-blood and plasma levels of TC, FC, SC, LC and AC as well as the ratio of AC to FC were not significantly different from those in the healthy controls (P < 0.1). However, after acetate or bicarbonate HD, erythrocyte, whole-blood and plasma levels of TC, FC, SC: LC and AC declined significantly as compared to either pre-dialysis or healthy control levels (P < 0.001). Moreover, after HD, the ratio of AC to FC was significantly higher in patients on acetate HD than either the pre-dialysis figure or that of patients on bicarbonate HD (P < 0.001). The ratio returned to normal with bicarbonate HD (P < 0.001). The observed discrepancies in response between acetate and bicarbonate HD may be due to the enhanced formation of acetyl-CoA and fatty acid synthesis during acetate HD. Med Sci Res 26:367-371 (C) 1998 Lippincott-Raven Publishers.