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Primary systemic carnitine deficiency Primary systemic carnitine deficiency is a rare, autosomal recessive disorder caused by mutations (including deletions) in the SLC22A5 gene coding for carnitine transporter protein OCTN2 (organic cation transporter novel 2) (33)

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The exact mechanisms are not fully understood but may involve reducing appetite, improving insulin signaling, and potentially influencing gut microbiota

We have seen this happen, and this can be particularly problematic if your kidney function is already lower due to CKD." Patients with advanced CKD (eGFR between 1530 mL/min/1.73 m) or end-stage kidney disease (eGFR below 15 mL/min/1.73 m) require close monitoring since clinical data in these groups is limited

This involves controlling humidity levels, ensuring adequate ventilation, and promptly addressing water leaks and dampness

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