Measurement of carnitine in hemodialysis patients – adaptation of an enzymatic photometric method for an automatic analyzer

Abstract Background: The main goal of this work was to describe the analytical characteristics of an enzymatic photometric test for carnitine determination and its automation using an Olympus analyzer. Methods: We used a test from Roche intended for manual processing and tried to apply it for use on an Olympus AU 400 analyzer. The analytical parameters of our modified technique were determined using external quality controls and kit controls, and by measurements in venous blood samples from 85 chronically hemodialyzed patients (before and after hemodialysis) and from 68 healthy blood donors serving as controls. Results: A reference value for free carnitine was estimated parametrically as 40.1±17.8μmol/L. The mean bias for eight control measurements was 5.1%. Sensitivity was calculated as the limit of quantification at 2.6μmol/L. The intra-assay coefficient of variation was 2.4%. The inter-assay coefficient of variation was 8.3%. Analytical recovery was 101.8%, 99.5% and 95.4%. Conclusions: The main advantages of our automated method in comparison to the original manual method are the smaller amounts of samples, reagents and diluents required and the shorter analysis time. As hemodialysis patients often suffer from carnitine deficiency, we conclude that its determination may be helpful for diagnostic verification. Clin Chem Lab Med 2006;44:983–6.