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In a similar study in ESRD patients also receiving 20 mg/kg levocarnitine 3 times per week after hemodialysis, 12- and 24-week mean pre-dialysis (trough) levocarnitine concentrations were 189 (N=25) and 243 (N=23) mol/L, respectively

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So, inadequate levels of vitamin B12 and folic acid can drastically alter immune responses and increase susceptibility to infections