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Since many metabolites of phase I are too lipophilic to be retained in the kidney tubules, a subsequent conjugation reaction with an endogenous substrate, such as glucuronic acid, acetic acid, sulfuric acid or an amino acid, results in formation of more polar and hydrophilic compounds that are sufficiently polar to be excreted by the kidneys

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The guidelines were published in March 2022 and concluded that there was inadequate evidence on the safety or efficacy of liposuction for lipoedema and raised concerns about possible major adverse reactions