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Since kidney function is reduced during AKI, activation of the urea cycle and subsequent urea generation together lead to a substantial rise in BUN 14,35

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However, new therapies are under investigation, for example, mitapivat, a small-molecule allosteric activator of PK has shown to induce a clinically relevant hemoglobin increase and improvement in hemolytic parameters in a phase II clinical trial (Grace et al., 2019b)