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Renal Impairment: In patients treated with GLP-1 receptor agonists, including Saxenda , there have been reports of acute renal failure and worsening of chronic renal failure, usually in association with nausea, vomiting, diarrhea, or dehydration, which may sometimes require hemodialysis

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However, evidence from research studies suggests that GLP-1 analogs may also reduce gastric acid secretion, which can impair the conversion of dietary B12 into its absorbable form and decrease binding to intrinsic factor, both of which are necessary for proper absorption