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The action on kidneys appears to be directly through the effects also on renin-secreting cells of the juxta-glomerular apparatus, whose stimulation may lead to increased natriuresis and reduce hyperfiltration, and indirectly by the reduction of angiotensin II levels, the increase in nitric oxide with consequently endothelial vasodilation and the improvement of risk factors of kidney disease (hyperglycemia, hypertension, obesity) (20)
Too much overwhelms protective mechanisms
But you are breastfeeding, and that one detail changes everything
(2023) 102:E35394
Existing NICE-approved therapies, including semaglutide and tirzepatide, already offer substantial benefits for eligible patients and are available through NHS pathways
Smoking cessation is strongly recommended at least one month before and one month after the intervention (tobacco can cause delayed healing) and necrosis
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