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Contrasting with a moderate elevation, a large increase in circulating homocysteine leads to an elevation of the plasma ratio of reduced aminothiols to total aminothiols for homocysteine and cysteine, which favors the occurrence of an antioxidant status (Andersson et al, 1995

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Dehydration, often precipitated by diuretics or large-volume paracentesis, reduces effective renal perfusion and may impair renal ammonia excretion, leading to increased systemic ammonia levels