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Because no specific clinical or laboratory features of HRS have been identified, diagnosis depends on (1) the presence of severe liver disease, (2) a rise in creatinine to greater than 1.5 mg/dL (25.6 mol/L), (3) no evidence of other renal disease by urinalysis and clinical history, and (4) lack of improvement in renal function with treatments that increase intravascular volume (such as stopping diuretics, or administration of fluids and/or albumin)

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206,210 Additionally, activation of GLP-1R has been demonstrated to promote cell survival during glucotoxic and lipotoxic conditions, excessive nitric oxide levels, Ca 2+ depletion, oxidative stress, and cytokine-induced endoplasmic reticulum stress in primary beta-cells and cell lines