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Right-hand dog bites need careful documentation because hand wounds have higher clinical concern due to tendons, joints, nerves, and infection risk

In a 2025 review, after 1,200 mg intravenously twice a week for six weeks, 37.5% of participants reported lighter skin compared with 18.7% in the placebo group, and the effect faded after about six months

Ceni E, Mello T, Galli A

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)