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In initial CKD stages skeletal resistance to the action of PTH may explain why low bone turnover predominates in a significant proportion of patients, together with other conditions that inhibit bone turnover such as reduced calcitriol levels, sex hormone deficiency, diabetes, Wnt inhibitors and uremic toxins

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The authors thank the Center for Advanced Equipment and Educational Support, Faculty of Agriculture, Kyushu University for the use of the ECL-detection imaging system and the plate-reader

Clinical mechanisms include: Tyrosinase enzyme inhibition reducing active melanin synthesis Free radical neutralisation reducing oxidative triggers for pigmentation Glutathione peroxidase support protecting cellular membranes from oxidative degradation Hepatic detoxification enhancement supporting liver clearance of toxins that contribute to dull, uneven skin Anti-inflammatory action reducing chronic low-grade dermal inflammation that worsens pigmentation Collagen precursor support indirectly supporting skin firmness and elasticity through reduced oxidative collagen degradation IV Glutathione Treatment Protocol at Our Mumbai Clinic The specific IV formulation administered to each patient at our Andheri West clinic is determined following a pre-treatment medical consultation