Nutritional Status and Carnitine Level in Kidney Transplant Recipients

IntroductionOverweight/obesity, malnutrition, and abnormalities in carnitine metabolism are recognized in kidney transplant recipients (KTRs).AimThe aim of this study was to evaluate the prevalence of nutritional abnormalities and carnitine status in KTRs.MethodsThe study was performed in 80 stable KTRs aged 52.4 ± 14.0 years, without carnitine supplementation. Nutritional status was determined using a 7-point Subjective Global Assessment, anthropometric measurements, and s-albumin level. Urinary excretion and serum concentration of total (TC), free (FC) carnitine were measured using enzymatic methods according to Cederblad.ResultsMean transplantation vintage and estimated glomerular filtration rate (Modification of Diet in Renal Disease; 4 points) were 82.5 ± 56.5 months and 42.0 ± 15.0 mL/min/1.73 m2, respectively. Overweight and obesity were noticed in 41% and 14% of patients, respectively. Signs of malnutrition were present in 64% (21/33) of the overweight patients, and in 91% (10/11) of the obese patients. KTRs with malnutrition (Subjective Global Assessment ≤5) were significantly older, with longer transplantation vintage, lower eGFR, higher body mass index (BMI), higher body fat, and decreased hand grip strength in comparison to KTR with good nutritional status (Subjective Global Assessment >5). In 8.6% of KTRs, deficiency of FC (in serum and urine) was observed. Carnitine (TC and FC) and FC/TC ratio were not correlated with anthropometric and laboratory parameters of nutritional status. Serum of TC and FC concentrations negatively correlated with graft function.ConclusionsPlasma carnitine deficiency (limited availability) can appear in the KTR group and does not correspond with signs of both malnutrition and obesity. In spite of overweight/obesity, KTRs showed features of malnutrition and they need thorough nutritional evaluation and appropriate nutritional interventions.