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Long-term hyperglycemia promotes renin and angiotensin II synthesis in mesangial cells, leading to elevated glomerular capillary pressure and permeability, which are key components in the development of proteinuria

As a result, nausea and fullness are most pronounced during treatment initiation or dose escalation

[DOI] [PMC free article] [PubMed] [Google Scholar] 42.Cardiovascular and renal outcomes by baseline albuminuria status and renal function: results from the LEADER randomized trial