In CKD, a decrease in viable nephrons and reduction in glomerular filtration rate (GFR) change the kidneys normal physiology and sodium balance.67 68 Even though an adaptive fractional increase in sodium excretion per individual nephron unit compensates for the reduced number of working nephrons, the kidneys inability to excrete sufficient amounts of sodium results in sodium retention, extracellular fluid expansion, and blood pressure increase.68 69 Likewise, the reninangiotensinaldosterone system is activated in CKD, further exacerbating sodium retention and causing vasoconstriction which could significantly raise blood pressure.69 Sodium retention and its association with blood pressure in CKD are often referred to as sodium-sensitive hypertension.70 Therefore, reducing salt intake is recommended to manage hypertension in patients with CKD.68 The natriuretic and diuretic effect of the ketogenic diet may help alleviate sodium retention and improve systemic and glomerular blood pressure
(16) "Data clearly demonstrate that GSH supplementation along with antidiabetic treatment helps restore the gut microbiome by enriching beneficial bacteria of healthy gut and reducing significantly the load of pathogenic bacteria" - study authors
Within the CNS, GLP-1R is found in neurons, astrocytes, and oligodendrocytes
Stimulation of the PI3K/Akt/mTOR protein synthesis pathway: Upon receptor activation, IGF-1 LR3 triggers intracellular cascades including PI3K and Akt phosphorylation
Decrease oxidative stress in the nervous system
In the SUSTAIN-6 trial, semaglutide was associated with a significant increased risk of diabetic retinopathy complications, including vitreous hemorrhage, blindness, or conditions requiring treatment with an intravitreal agent or photocoagulation (HR 1.76, 95% CI 1.112.78) [27]
