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It should be kept away from strong chelators (such as high levels of EDTA and related sequestrants), reducing sugars, thiol-bearing actives, and high concentrations of direct acids (for example ascorbic acid or alpha-hydroxy acids at low pH), all of which can compete for the copper center or disrupt the peptide-metal bond and shift the characteristic blue color toward brown or colorless degradation products

demonstrated sustained improvement in renal function in a 31-day randomized, double-blinded, placebo-controlled trial of 15 patients with advanced CKD, who had received intermittent doses of rhIGF-1 [33]