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most cardiovascular outcome trials excluded patients with end-stage renal disease (ESRD) or those receiving maintenance dialysis

(2004) 89(1):F258

Defective DNA replication impairs mitochondrial biogenesis in human failing hearts

However, in most cases, the side effects were mild

Any vendor claiming IGF-1 LR3 is "proven to increase muscle mass in humans" is either misrepresenting the evidence or referencing surrogate markers, not hard clinical endpoints