Abstract
Intradialytic Hypotension and Left Ventricular Function Improved After Intravenous Levo Carnitine Therapy in a Pediatric Hemodialysis Patient
Highlights
Supplementation of carnitine is essential in hemodialysis (HD) patient as it is a very paramount nutrient for the transfer of long-chain fatty acids across mitochondria and for subsequent beta oxidation [1]
It is cardinal in patients on dialysis who suffer from severe carnitine deficiency as they tend to lose significantly from dialysis
Significant intradialytic hypotension (IH) secondary to carnitine deficiency has been well documented in pediatric HD patients [2,3,4,5,6]
Summary
The significant decline of endogenous carnitine levels has been well confirmed in a single hemodialysis session. Intradialytic hypotension secondary to carnitine deficiency is commonly due to depressed cardiac function During hemodialysis, both oral carnitine and intravenous carnitine has been effective in adults by reducing the signs and symptoms. In children, intravenous carnitine may be more effective in the management of intradialytic hypotension and improving heart function. Case presentation: We report a 9-year-old girl who is a known case of end-stage renal failure secondary to hypoplastic kidneys Her dialysis is complicated with left ventricular systolic dysfunction, and tertiary hyperparathyroidism for which she underwent parathyroidectomy. She was significantly complicated with intradialytic hypotension which warranted her ultra filtrate rate not exceeding 0.2ml/kg/min She was investigated for carnitine levels which confirmed secondary carnitine deficiency. We describe a pediatric patient with secondary carnitine deficiency in a pediatric hemodialysis patient and its successful management with intravenous carnitine
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