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(PubMed) Delle Chiaie R, Pancheri P, Scapicchio P

Kidney Dysfunction: While the kidneys do not directly excrete vitamin B12 efficiently, impaired renal function may lead to elevated serum B12 levels by reducing the clearance of B12-binding proteins or altering their metabolism, thereby contributing to B12 accumulation 8

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levels above 400 pg/mL suggest high probability of acute decompensated heart failure (per ACC/AHA guidelines)

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