Clinical management of dialysis-related carnitine deficiency: three case studies.

Though future clinical trials will help establish better-defined guidelines for L-carnitine as a therapeutic agent, clearly there are subsets of dialysis patients who can benefit from L-carnitine therapy, as evidenced by the case studies described in this article. In each of these cases, L-carnitine significantly improved the patient's quality of life by increasing muscle strength and energy levels, increasing hematocrit, minimizing intradialytic morbidities that interfere with dialysis prescription, or improving cardiac function. Given the limited side effects, a trial of L-carnitine with ongoing evaluation of beneficial effect is a reasonable therapeutic option for chronic dialysis patients with clinical conditions related to DCD.