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Renal impairment affects not only the renal excretion of a drug but may also alter metabolism and active transport in the kidney, liver or gut and affect absorption, tissue distribution and plasma protein binding [13]

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Lose weight or address body composition changes: Ask your clinician about GLP-1s (like semaglutide or tirzepatide), other meds like Contrave or metformin, supplements like berberine, and other lifestyle strategies