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Furthermore, peripheral insulin resistance triggered by uremia, metabolic acidosis and low-grade inflammation is common in CKD (80), leading to intra-portal hyperinsulinemia, but does not necessarily increase hepatic sensitivity to GH because of the reduced hepatic expression of IGF-I and GHR mRNA (81)

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10.3389/fnins.2015.00469 [DOI] [PMC free article] [PubMed] [Google Scholar] Li Z., Mizuno S., Nakamura T