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NAD+ is vital for several energy-generating processes: Glycolysis : NAD+ aids enzymatic reactions catalyzed by GAPDH and lactate dehydrogenase [2] TCA cycle : NAD+ works as a coenzyme for three rate-limiting enzymes (-ketoglutarate dehydrogenase, isocitrate dehydrogenase 3, and malate dehydrogenase) [2] Oxidative phosphorylation : NADH produced in the TCA cycle donates electrons to the electron transport chain that generates most of the cell's ATP [2] The balance between oxidized NAD+ and its reduced form NADH (the NAD+/NADH ratio) shows the cell's metabolic state

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Oxidative metabolism also occurs in the kidneys but at much lower rates than in the liver (Lash et al