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Normalization was carried out to account for technical variation, and keratins identified in blank Schirmer strip controls were removed, as previously published 30

Kidney dysfunction is associated with retention of many metabolites, including homocysteine and SAH

Since mitochondrial oxidative phosphorylation depends on local NADH availability, whereas cytosolic NADPH supports reductive buffering, disproportionate redistribution between compartments may amplify localized redox imbalance even when total cellular NAD levels appear preserved

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