Reuter, S.Faull, R.Evans, A.2009-11-242009-11-242008Nephrology, 2008; 13(1):3-161320-53581440-1797http://hdl.handle.net/2440/53709The definitive version may be found at www.wiley.comIt 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.enHumansKidney Failure, ChronicAnemiaAscorbic AcidVitaminsVitamin B ComplexCarnitineTreatment OutcomeRenal DialysisPrevalenceFollow-Up StudiesSouth AustraliaWestern AustraliaJournal article002008021910.1111/j.1440-1797.2007.00817.x0002534253000022-s2.0-3814901240843792