In patients on maintenance hemodialysis several factors reduce the body stored carnitine which could lead to dyslipidemia, anemia, and general health in these patients. We evaluated the effect of oral L-carnitine supplementation on lipid profiles, anemia, and quality of life (QOL) in hemodialysis patients. In a randomized, double-blinded, placebo-controlled trial, end-stage renal disease (ESRD) patients on hemodialysis received either L-carnitine 1 g/d (n=24) or placebo (27 patients) for 16 weeks. At the end of the study, there was a significant decrease in triglyceride (-31.1±38.7 mg/dL, P=0.001) and a significant increase in HDL (3.7±2.8 mg/dL, P0.05). Erythropoietin dose was significantly decreased in both the carnitine (-4750±5772 mg, P=0.001) and the placebo group (-2000±4296 mg, P