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First, due to the retrospective nature of the study, a causal association between RA and ESRD could not be confirmed

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This rationale aligns with emerging priorities in cardio-oncology, where patients treated with anthracyclines face substantial risk of cardiotoxicity and where metabolic interventions may be especially valuable, particularly in cancers such as breast, ovarian, and prostate, in which cachexia is uncommon but treatment-related weight gain is frequent 26,27