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In macrophages, IS triggers toxicity by increasing OS and lipid metabolism abnormalities, linking gut microbiota-derived toxins to atherosclerosis and bone loss ( 5 Discussion The intricate interplay between immune dysregulation and CKD-MBD significantly amplifies clinical risks, notably fracture susceptibility, cardiovascular complications, and mortality

Systematic review of 4 studies (3 RCTs + 1 single-arm trial)