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A possible explanation is that the reduction in ADC is caused by a decline in renal perfusion, GFR or TKV

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doi: 10.1016/j.immuni.2020.02.002 73 WestAPKhoury-HanoldWStaronMTalMCPinedaCMLangSMet al

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Working with your doctor to select the optimal delivery and hormone combination can also enhance safety