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While these findings suggest potential utility for early detection and risk stratification, multicenter validation and longitudinal follow-up are needed to confirm that alterations in carnitine levels precede eGFR decline and are not merely a consequence of impaired renal clearance

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Erbas, H., Aydogdu, N., Usta, U., and Erten, O

The pyruvate carboxylase is activated by enhanced brain function, as shown by an increase in CO 2 fixation with brain activity in the awake rat brain (z et al., 2004)

The combination is used in clinical practice under physician supervision based on mechanistic reasoning, preclinical evidence, and clinical experience