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Chronic administration of high doses of oral levocarnitine in patients with severely compromised renal function or in ESRD patients on dialysis may result in accumulation of the potentially toxic metabolites, trimethylamine (TMA) and trimethylamine-N-oxide (TMAO), since these metabolites are normally excreted in the urine

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Information sources and search The literature was explored using the MEDLINE (via PubMed) and Web of Science databases, including all articles published from the inception up February 2020