Background: Carnitine deficiency is a common condition in hemodialysis patients. There have been numerous reports on the efficacy of levocarnitine therapy in hemodialysis patients, including different views. Reported effects of levocarnitine are: (1) improvement of renal anemia, (2) improvement of cardiac functions, (3) effects on muscle spasm and asthenia, (4) anti-atherogenic effects, (5) anti-oxidant and anti-inflammatory effects, and (6) inhibitory effects on dialysis hypotension.
Summary: Here, I present the effects of levocarnitine on renal anemia in hemodialysis patients with carnitine deficiency, focusing on the effect on dose reduction in erythropoiesis-stimulating agents and the influence on erythropoiesis resistance index. We also describe the effects on cardiac functions based on changes in cardiac ultrasonography. Key Message: To confirm the efficacy of levocarnitine therapy clinical studies would be required as well as the study of carnitine supplementation therapy for hemodialysis patients with carnitine deficiency.
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