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Kidney function tests: your eGFR and creatinine levels should be checked every 3-4 months initially, rather than the usual 6-12 months for stable CKD Hydration status: regular assessment for signs of dehydration, particularly during the first few months when nausea is most common Blood pressure monitoring: weekly home blood pressure checks, as your medication needs may change with weight loss Electrolyte levels: sodium, potassium, and other electrolytes should be monitored more frequently, particularly if you experience significant nausea or reduced appetite Medication review: regular assessment of all your medications, as doses may need adjusting with weight loss and changing kidney function Cardiovascular risk factors: CKD increases heart disease risk, so lipid (fat) and diabetes markers need monitoring alongside kidney function Your GP should coordinate this monitoring with your kidney specialist

Strikingly, lysosomes are essential for the functional maintenance and survival of neurons

p53 tumour-suppressor caution Because FOXO4-DRI intervenes in the p53 pathway, which is critical for tumour suppression, there is theoretical concern that interfering with p53 dynamics might carry oncogenic risk

Addressing these knowledge gaps will be essential in translating the scientific promise of PSYs into viable, evidence-based therapies for people living with MS (Figure 2)

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It is a medical intervention best delivered through medical weight loss programs designed for clinically significant obesity and its associated metabolic conditions