CORRELATION BETWEEN SERUM CARNITINE LEVELS AND ERYTHROCYTE OSMOTIC FRAGILITY IN HEMODIALYSIS-PATIENTS

The relationship between serum carnitine levels and erythrocyte osmoti c fragility was investigated in 26 chronic hemodialysis patients (10 m ales and 16 females, mean age: 57.3 +/- 13.5 years). Serum total-carni tine (TC), free-carnitine (FC) and acyl-carnitine (AC) levels were det ermined by a spectrophotometric method. Erythrocyte osmotic fragility was measured with a coil planet centrifuge. Serum TC levels were 39.9 +/- 13.4 mu mol/l (mean +/- SD), FC levels were 21.8 +/- 7.8 mu mol/l and AC levels were 18.0 +/- 9.6 mu mol/l. 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 co mparison with the normal range. There were no significant differences in hemolysis points between a recombinant human erythropoietin (rhEPO) -treated group and nontreated group. 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 ). Dose requirement of rhEPO maintaining target hematocrit correlated with serum TC (r = -0.54, p < 0.05) and FC levels (r = -0.50, p < 0.05 ). These data support that low serum carnitine levels accelerate eryth rocyte osmotic fragility. Carnitine may contribute to the metabolism o f erythrocyte membrane and have an impact on the efficacy of rhEPO in correcting renal anemia.