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https://hdl.handle.net/2440/53709
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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 |
DOI: | 10.1111/j.1440-1797.2007.00817.x |
Published version: | http://dx.doi.org/10.1111/j.1440-1797.2007.00817.x |
Appears in Collections: | Aurora harvest Medical Education Unit publications |
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