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Identifying advanced disease remains critical for timely hepatology referral, portal hypertension screening, and hepatocellular carcinoma surveillance

Schedule prompt medical evaluation (within 24-48 hours) for: Gradually worsening shortness of breath over days to weeks Dyspnea with exertion that is new or significantly worse than baseline Breathing difficulty accompanied by persistent cough or fever Leg swelling, weight gain, or orthopnea (difficulty breathing when lying flat) Respiratory symptoms associated with severe ongoing nausea, vomiting, or inability to maintain hydration Patients should not discontinue GLP-1 medications without medical guidance (except in cases of suspected severe allergic reactions), but should contact their healthcare provider promptly to discuss respiratory symptoms

Homocysteine and lipid peroxidation in haemodialysis: Role of folinic acid and vitamin E

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