Caruso 1998.

Study characteristics
Methods	Study characteristics Study design: parallel RCT Study duration: not reported Study follow‐up: 9 months
Participants	Baseline characteristics Country: Italy Setting: dialysis centre (1 site) Inclusion criteria: > 40 years; dialytic age > 1 year; rHuEPO therapy > 9 months; HCT 30% to 35%; normal iron status Randomised number (intervention/control): 15/16 Dialysis modality: HD Mean age ± SD (years): intervention group (67.6 ± 13.43); control group (65.69 ± 14.54) Sex (M/F): intervention group (11/4); control group (5/11) Mean dialysis duration ± SD (years): intervention group (3.73 ± 2.49); control group (5.56 ± 4.38) Exclusion criteria: L‐carnitine intervention within 2 months; severe hyperparathyroidism (PTH > 150); signs of aluminium intoxication; uncontrolled hypertension; severe liver disease; causes of anaemia other than uremia; pregnancy
Interventions	Intervention group L‐carnitine (IV): 1000 mg at each dialysis session for 6 months Control group Placebo
Outcomes	Outcomes relevant to this review Anaemia‐related markers: Hb, EPO dose Death: any cause; cardiac
Notes	Funding source: not mentioned, but an author was from the Sigma Tau company
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Study was described as "according to a randomization list"; method of randomisation was not reported
Allocation concealment (selection bias)	Unclear risk	Insufficient information to permit judgement
Blinding of participants and personnel (performance bias)	Low risk	Quote: "double‐blind placebo‐controlled" study
Blinding of outcome assessment (detection bias) Anaemia‐related markers	Low risk	Quote: "double‐blind placebo‐controlled" study
Blinding of outcome assessment (detection bias) Death	Low risk	Quote: "double‐blind placebo‐controlled" study
Incomplete outcome data (attrition bias) Anaemia‐related markers	Low risk	Missing outcome data balanced in numbers across intervention groups
Incomplete outcome data (attrition bias) Death	Low risk	No missing outcome data
Selective reporting (reporting bias)	Unclear risk	The study protocol is not available
Other bias	High risk	Funding source: not mentioned, but an author was from the Sigma Tau company