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Subgroup analysis on the design of randomized controlled trials, 3 studies with cross-over trials demonstrated the odds ratio of dialysis-related hypotension was 0.13 (95% CI [0.0063.10], p = 0.21, I 2 = 90%) comparing L-carnitine to placebo

A large-scale clinical trial (1019 patients) failed to demonstrate significant efficacy, attributed to a robust placebo effect, insufficient dosing or formulation changes [147]

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High doses are more likely to produce side effects