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Metabolites that significantly correlated with PROMIS-Fatigue T -scores were overrepresented by the steroid hormone biosynthesis pathway (KEGG ID: M00107), including androgen and estrogen metabolism (SMPDB ID: SMP0000068) and androstenedione metabolism (SMPDB ID: SMP0030406) (Figure 4C), which included androsterone sulfate ( r = 0.26, p = 0.0009), epiandrosterone sulfate ( r = 0.25, p = 0.0016), etiocholanolone glucuronide ( r = 0.19, p = 0.018), and dehydroepiandrosterone sulfate (DHEA-S) ( r = 0.18, p = 0.023)

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F., Ranieri, F., Toigo, G., Vasile, A., Ciman, M., Rizzoli, V., Moracchiello, M., and Campanacci, L

Sustained CaptoprilInduced Reduction in Blood Pressure Is Associated With Alterations in GutBrain Axis in the Spontaneously Hypertensive Rat. Journal of the American Heart Association 8: e010721
However, the presence of rebound hyperammonaemia often necessitates treatment with multiple HD sessions, which can cause hypotension and rapid osmotic shifts that further compromise the haemodynamic stability of the patient 44
