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Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/53709

Type: Journal article
Title: L-carnitine supplementation in the dialysis population: Are Australian patients missing out?
Author: Reuter, S.
Faull, R.
Evans, A.
Citation: Nephrology, 2008; 13(1):3-16
Publisher: Blackwell Publishing Asia
Issue Date: 2008
ISSN: 1320-5358
1440-1797
Statement of
Responsibility: 
Stephanie E Reuter, Randall J Faull and Allan M 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? This review examines the previous research associated with L-carnitine administration to chronic dialysis patients for the treatment of anaemia, cardiac dysfunction, dyslipidaemia and/or dialytic symptoms, and discusses whether supplementation is warranted within the Australian setting.
Keywords: Humans; Kidney Failure, Chronic; Anemia; Ascorbic Acid; Vitamins; Vitamin B Complex; Carnitine; Treatment Outcome; Renal Dialysis; Prevalence; Follow-Up Studies; South Australia; Western Australia
Description: The definitive version may be found at www.wiley.com
RMID: 0020080219
DOI: 10.1111/j.1440-1797.2007.00817.x
Appears in Collections:Medical Education Unit publications
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