The role of L-carnitine in treating anemia hyporesponsive to erythropoietin

The anemia of end-stage renal disease is an area with many facets that interact in complex ways that continue to be discovered. Dialysis-related carnitine deficiency (DCD) recently has been identified as an important diagnostic consideration in patients hyporesponsive to recombinant human erythropoietin (rHuEPO). Clinical studies suggest that treatment of DCD with levocarnitine can favorably impact the outcome of hyporesponse to rHuEPO treatment. Possible explanations for this include an enhancement of erythrocyte membrane stability and alterations in sodium-potassium ATPase activity within the erythrocyte, which seems to improve erythrocyte life span. The National Kidney Foundation L-Carnitine Practice Recommendations, as well as Medicare reimbursement guidelines, provide clinicians direction on levocarnitine treatment of anemia hyporesponsive to rHuEPO. Disclosure statement: The development of this article was supported by an unrestricted educational grant from Sigma-Tau Pharmaceuticals, Inc.