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Third, TMAO may potentially disrupt the equilibrium of renal electrolytes and water transport by inhibiting sodium and water reabsorption in the kidneys, resulting in sodium retention and volume expansion, characteristic features of chronic kidney disease ( Figure 4 Besides, TMAO may directly harms kidney structure, causing glomerular hypertrophy, tubulointerstitial fibrosis, and renal inflammation in animals, which promoting the progression of CKD
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