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Adems, durante la HD , debido a que el peso molecular relativo de la L-carnitina es relativamente pequeo, es soluble en agua y no se une fcilmente a las protenas plasmticas, en pacientes con insuficiencia renal crnica en dilisis, debido a una menor ingesta diettica, una sntesis endgena limitada y la eliminacin por hemodilisis, la concentracin plasmtica de carnitina libre puede disminuir en un 70%