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Pharmacol Ther (2011) 34:108897
It has also been proposed as a treatment for several symptoms or complications of dialysis, including intradialytic arrhythmias and hypotension, low cardiac output, interdialytic and post-dialytic symptoms of malaise or asthenia, general weakness or fatigue, skeletal muscle cramps, and decreased exercise capacity or low peak oxygen consumption
For the most part, reactions are mild and go away in a few days
In the United States, Medicare coverage for L-carnitine is available for patients who have been on dialysis therapy for at least 3 months, have a plasma free carnitine level less than 40 mol/L, and have erythropoietin-resistant anemiathat has not responded to standard erythropoietin dosageand for which other causes have been investigated and adequately treated. 195 Hyporesponsiveness to ESAs is not specifically defined other than having a persistent Hct less than 30% despite erythropoietin dosage that is considered clinically appropriate to treat the particular patient. The statement There is insufficient evidence to recommend use of L-carnitine in the management of anemia in patients with CKD is supported by results from 6 available RCTs of IV L-carnitine administration to ESA-treated HD patients (Table 32)
