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Nonrandomized evaluations, pharmacokinetic studies, animal/laboratory studies, and general reviews were excluded, and duplicated publications reporting the same groups of patients were also excluded (Figure S1 in Supplementary Material available online at 2.3

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In several multi-center longitudinal studies involving hemodialysis cohorts, the administration of IV Levocarnitine demonstrated a significant reduction in the ESA Resistance Index. Numerical data from recent trials indicates: Anemia Management: Patients receiving IV Levocarnitine showed an average 15% to 25% reduction in the required dose of Erythropoietin (EPO) to maintain target hemoglobin levels