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We moved away from IV because intracellular NAD+ levels, which is where the benefit actually happens, do not reliably increase with IV administration

Acidosis may damage the epithelium and alter permeability, as hyperpermeability has been reported in both cattle and swine mucosa with acidosis [128,129]

Chen, A

Nevertheless, this data indicates that special attention should be paid to the use of rhGH in children with CKD, especially when given over prolonged periods [154]

Many are FDA-cleared or regulated as 361 HCT/P biologics for homologous use