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|Title:||L-carnitine supplementation in the dialysis population: Are Australian patients missing out?|
|Citation:||Nephrology, 2008; 13(1):3-16|
|Publisher:||Blackwell Publishing Asia|
|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|
|Appears in Collections:||Medical Education Unit publications|
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