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It has also been proposed as a treatment for several symptoms or complications of dialysis, including intradialytic arrhythmias and hypotension, low cardiac output, interdialytic and post-dialytic symptoms of malaise or asthenia, general weakness or fatigue, skeletal muscle cramps, and decreased exercise capacity or low peak oxygen consumption

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205 Therefore, using the lowest effective dose of metformin and supplementing with folate may be advisable for maintaining healthy homocysteine levels

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