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The cascade of the systemic RAAS starts with the liver angiotensinogen (AGT), which is converted to Angiotensin I (ANG I) by renin, a hormone secreted by the juxtaglomerular cells

In animal models of Type 1 diabetic nephropathy, both DPP4 deficiency and linagliptin treatment have been shown to reduce kidney damage

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As such, we did not consider open-label status as a source of bias, given that measurement of HbA 1c is an objective outcome and thus is not affected by blinding status [15]