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Gut-derived uremic toxins including indoxyl sulfate (IS), p-cresyl sulfate (pCS), and trimethylamine N-oxide (TMAO) are significantly elevated in DKD patients (170)

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In addition, L-Carnitine also plays a major part in protecting cellular membranes, preventing fatty acid accumulation, modulating ketogenesis and glucogenesis and in the elimination of toxic metabolites 1 The Role of l-Carnitine in Mitochondria, Prevention of Metabolic Inflexibility and Disease Initiation Virmani et al