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Chronic oral administration of high doses of levocarnitine in patients with severely impaired renal function or end-stage renal disease (ESRD) and dialysis patients may lead to accumulation of the potentially toxic metabolites trimethylamine (TMA) and trimethylamine-N-oxide (TMAO), as these metabolites are normally excreted in the urine

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However, it is known that CuO-NPs can exhibit toxicity in rats when administrated orally into 1000 mg/kg for 28 days and result in ROS accumulation

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