Effectiveness of L-Carnitine for the Treatment of Erythropoietin-Resistant Renal Anemia: A Randomized, Double-Blind, Placebo-Controlled Pilot Trial

These findings provide evidence to support the National Kidney Foundation's practice recommendations with respect to the clinical use of L-carnitine for renal anemia. While the exact mechanism is yet to be elucidated, it is proposed that L-carnitine treatment improves carnitine palmitoyltransferase activity via carnitine pool normalization, thereby resulting in stabilization of the erythrocyte membrane. If this is the case, then it is feasible that a dual approach to increase erythrocyte production and lifespan through co-administration of ESA and L-carnitine provides a viable treatment option for ESA-resistant patients.