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79,80 This phenomenon has been seen in patients with chronic kidney disease (CKD), and a phase II CKD cohort study found that plasma Leu and valine are significantly decreased in CKD patients compared with normal controls

However, care must be taken when using HA, as it has been shown to regulate the TME and promote the malignant phenotype of cancer cells, and lead to multidrug resistance (Markowska et al., 2023)