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While the medulla is hyperosmolar to concentrate urine, its restricted blood supply results in a naturally hypoxic state

These include diabetes or high blood pressure that is not well managed anticoagulation or bleeding disorder allergies or hypersensitivity to steroid medication or anesthesia infection at the site of the injection congestive heart failure While doctors consider spinal injections generally safe, severe complications may occur in rare cases

Published human clinical trials for KPV in IBD or arthritis are lacking

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