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Linagliptin has a hepatic route of excretion and can be used without dose adjustment in patients at all stages of renal disease (90)
But "continuing indefinitely without a check-in" is a mistake, not a strategy
The goal is always protein first, even if the total volume is small
While these medications are generally well tolerated, gastrointestinal side effects such as nausea and constipation are common and have been reported to limit therapy [2, 3, 4]
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