How often do you check carnitine levels in your patients with end stage kidney disease on hemodialysis?  

About 10 years ago I used to check carnitine levels in ESRD patients with intradialytic hypotension commonly. If low then I would treat with levocarnitine. At some point I gave up on the practice not because it was not working but because it was hard to determine if it was working or not. I am aware...

I have also checked carnitine only a couple of times over the last few years - once for intradialytic hypotension in a setting of cardiomyopathy on a young patient and another one for ESA-resistant anemia. Cartinine was low in both patients and the supplementation did improve intra-dialytic hypotens...