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In one prospective cohort study of CKD patients, mortality risk was 2.8 times higher in those with higher TMAO levels In another study, patients with end-stage renal disease on dialysis had TMAO levels forty times higher than the control group (Hai et al

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This results in lipid peroxidation damage, inactivation of functional proteins, and DNA strand breaks within the bacterial membrane, which effectively inhibits bacterial growth and proliferation [282]

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