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Pinch a 2 cm skin fold and insert the needle at a 4590 angle

The US National Kidney Foundation did not recommend routine administration of L-carnitine to subjects undergoing dialysis yet encouraged the development of trials in patients with select symptoms that do not respond to standard therapy, i.e., persistent muscle cramps or hypotension during dialysis, severe fatigue, skeletal muscle weakness or myopathy, cardiomyopathy, and anemia requiring large doses of erythropoietin (74, 75)

2 For a 505(b)(2) sponsor, these new indications represent a value continuum where they can repurpose an established molecule for a specialized population with much lower risk