Despite its use in the treatment of renal anaemia, no adequately controlled studies have examined impact of L-carnitine administration in the patient population for which it is indicated (i.e. those hyporesponsive to erythropoiesis-stimulating agents [ESA]). This randomised, double-blind, placebo-controlled pilot study evaluated the potential benefit of L-carnitine supplementation for the treatment renal anaemia in chronic haemodialysis patients who were hyporesponsive to ESA treatment.