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While tirzepatide is not primarily eliminated through the kidneys, the gastrointestinal effects of the medication, including potential nausea, vomiting, and diarrhea, could lead to dehydration and electrolyte imbalances that may be particularly problematic in patients with compromised kidney function

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Some LC variants also modulate NGF activity, influence hormone levels, and regulate synaptic morphology and neurotransmitter transmission, including acetylcholine [44]

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You should not take Genvoya if you have reduced kidney function or other kidney problems