Carnitine Deficiency after Long-Term Continuous Renal Replacement Therapy

Caroline Van de Wyngaert; Joseph P Dewulf; Christine Collienne; Pierre-François Laterre; Philippe Hantson

doi:10.1155/2022/4142539

Carnitine Deficiency after Long-Term Continuous Renal Replacement Therapy

Case Rep Crit Care. 2022 Aug 17:2022:4142539. doi: 10.1155/2022/4142539. eCollection 2022.

Authors

Caroline Van de Wyngaert¹, Joseph P Dewulf², Christine Collienne¹, Pierre-François Laterre¹, Philippe Hantson^{1

3}

Affiliations

¹ Department of Intensive Care, Cliniques St-Luc, Université Catholique de Louvain, 1200 Brussels, Belgium.
² Department of Clinical Chemistry, Cliniques St-Luc, Université Catholique de Louvain, 1200 Brussels, Belgium.
³ Louvain Centre for Toxicology and Applied Pharmacology, Université Catholique de Louvain, 1200 Brussels, Belgium.

Abstract

A 60-year-old man was admitted in the intensive care unit (ICU) for a rapidly progressive respiratory failure due to SARS-CoV-2 infection. He developed numerous complications including acute kidney injury (AKI) requiring prolonged continuous renal replacement therapy (CRRT). Enteral feeding was initiated on day 8. Despite nutritional management, there was a remarkable amyotrophy and weight loss. On day 85 in the ICU, the patient became progressively unresponsive. An extensive metabolic workup was performed, and blood results showed hyperammoniemia and hypertriglyceridemia. Plasma free carnitine level was low, as was also copper. After carnitine supplementation, the neurological condition rapidly improved, and metabolic perturbations regressed. Prolonged CRRT may be complicated by clinically significant deficiency in micronutrients and trace elements.

Publication types

Case Reports