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Namun, pada pasien gagal ginjal kronis, terutama yang menjalani hemodialisis, mengalami defisiensi L-carnitine karena asupan yang berkurang atau bersihan yang meningkat selama dialisis, sehingga menimbulkan beberapa gejala seperti anemia, hipotensi berkaitan dengan dialisis, kerusakan otot jantung, dan malnutrisi.

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