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Delayed shipments sitting in warm delivery vehicles represent a dual risk: both the manufacturing quality (if the vial came from a facility with sterility issues) and the cold chain integrity (if the vial spent too long at inappropriate temperatures)

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doi:10.2174/1570159X17666191120154128

Given the reabsorption of renin by proximal tubule cells through megalin, and the broad expression of ACE within the kidney, allowing locally synthetized ANG II independent action, the interference of SGLT-2-i with intrarenal RAS could explain such results