L-carnitine supplementation in the dialysis population: are Australian patients missing out?

Nephrology
Stephanie E ReuterAllan Evans

Abstract

It has been widely established that patients with end-stage renal disease undergoing chronic haemodialysis therapy exhibit low endogenous levels of L-carnitine and elevated acylcarnitine levels; however, the clinical implication of this altered carnitine profile is not as clear. It has been suggested that these disturbances in carnitine homeostasis may be associated with a number of clinical problems common in this patient population, including erythropoietin-resistant anaemia, cardiac dysfunction, and dialytic complications such as hypotension, cramps and fatigue. In January 2003, the Centers for Medicare and Medicaid Services (USA) implemented coverage of intravenous L-carnitine for the treatment of erythropoietin-resistant anaemia and/or intradialytic hypotension in patients with low endogenous L-carnitine concentrations. It has been estimated that in the period of 1998-2003, 3.8-7.2% of all haemodialysis patients in the USA received at least one dose of L-carnitine, with 2.7-5.2% of patients receiving at least 3 months of supplementation for one or both of these conditions. The use of L-carnitine within Australia is virtually non-existent, which leads us to the question: Are Australian haemodialysis patients missing out? Th...Continue Reading

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Citations

Jan 18, 2008·Nephrology·John Kelly
Apr 20, 2010·Nutrition & Metabolism·Judith L FlanaganQian Garrett
Jul 29, 2010·Journal of Pediatric Endocrinology & Metabolism : JPEM·Jane LoftusPaul Dimitri
Jan 31, 2013·Hemodialysis International·Stephanie E Reuter, Allan M Evans
May 1, 2021·Nutrients·Hiroyuki TakashimaMasanori Abe

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