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In addition, the National Kidney Foundation has declared that the administration of levocarnitine to dialysis patients should be considered for the following four clinical conditions [60]: (1) patients with anemia who are unable to maintain optimal hemoglobin or hematocrit levels with the use of ESA, despite adequate iron status, and with no other identifiable cause of anemia or a hypo-response to ESA

The bottom line: the supply crunch is easing, but the arms race in manufacturing is just getting started