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The 2000 KDOQI Clinical Practice Guidelines for Nutrition in Chronic Renal Failure Work Group extensively reviewed the evidence regarding l-carnitine supplementation for diverse symptoms and complications of chronic dialysis and agreed that there was insufficient evidence to support or refute the routine use of l-carnitine for metabolic abnormalities in maintenance dialysis patients, including hypertriglyceridaemia, hypercholesterolaemia, and anaemia or for 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 [8]