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Indoxyl sulfate induces oxidative stress and inflammation by activating ERK/p38 MAPK, NF-B pathways, and the RAS

First, before starting a patient on a GLP-1 agonist, you may wish to check the FDA Drug Shortages List to ensure the patient can reliably get refills

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No dose adjustment is required in renal impairment according to the UK SmPC, though renal function should be monitored, especially if significant gastrointestinal adverse effects or dehydration occur