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Doctors Best Benfotiamine and Pure Encapsulations Alpha Lipoic Acid are two excellent choices

Lower the dose or increase the stop interval before major surgery for eGFR 30 to 60, and review renal function tests less than 30 days pre-op

A., Karthikeyan, M., Lackey, M., Villavicencio, D

Salami, an associate professor of urology at the University of Michigan School of Medicine

Dipeptidyl peptidase-4 (DPP-4), also known as CD26, is widely expressed in the epidermis and on multiple immune cell subtypes, and preclinical studies demonstrating cutaneous vasculitis in non-human primates with some, but not all, DPP-4 inhibitors [20], has heightened awareness of the potential consequences of DPP-4 inhibition on the skin

But this is far from certain