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In many experimental animal models, MTX has been found to increase serum urea and creatinine levels (Reference Moodi, Hosseini and Abedini16,Reference Tousson, Zaki and Abu-Shaeir50,Reference Jafaripour, Naserzadeh and Alizamani51) , but there are also studies showing that MTX reduces serum urea concentration (Reference Budancamanak, Kanter and Demirel52Reference Severin, Campagno and Brandoni54)

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Several studies have also shown that L-carnitine lowers the ketone body -hydroxybutyrate [24,88,90] and that it is dose dependent [91]

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