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Firstly, assuming that mitochondria are the main source of endogenous free radicals[239, 240], it has been previously reported that species with higher metabolic rates have shorter maximum lifespan due to superoxide anion radical accumulation that lead to cell damage, hastening aging[241]

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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