L-carnitine is an endogenous compound that has important roles in fatty acid oxidation. Patients with end-stage renal disease (ESRD) who are undergoing haemodialysis may develop a secondary L-carnitine deficiency. Following oral administration of L-carnitine, enterobacteria generate ??-butyrobetaine and trimethylamine with the latter substance extensively N-oxygenated in the liver, to form trimethylamine-N-oxide. Given that patients with ESRD have qualitatively different and higher bacterial populations in the small intestine as compared with healthy subjects, increased formation of trimethylamine and accumulation of trimethylamine-N-oxide would be expected. The clinical significance of these amines is related to their potential to form the carcinogen N-nitrosodimethylamine, contribution to neurological toxicity and "uraemic breath". / The pharmacokinetics of oral L-carnitine display clear non-linearity above a dose of 0.5 g three times a day with an associated increase in plasma concentrations of trimethylamine and trimethylamine-N-oxide. Oral administration of L-carnitine to patients with ESRD undergoing haemodialysis increased plasma concentrations of this substance to levels seen in individuals with normal kidney function and evidence was provided for the accumulation of trimethylamine-N-oxide. / Thesis (PhD)--University of South Australia, 2006.
| Identifer | oai:union.ndltd.org:ADTP/286488 |
| Creators | Bain, Marcus A |
| Source Sets | Australiasian Digital Theses Program |
| Language | English |
| Detected Language | English |
| Rights | copyright under review |
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