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Renal carnitine loss may also affect the morphology and function of red blood cells and reduce the oxygen carrying and releasing capacity of red blood cells, thereby reducing tissue oxygen supply (including the kidney), and tissue hypoxia activates hypoxia-inducible factor 1 (HIF-1), which in turn reduces OCTN2 expression through the HIF-1-PPAR signaling pathway

As such, the mechanism underpinning the induction of eryptosis by heavy metals is of considerable interest, and it is under investigation in various studies

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This is because, despite the diagnostic accuracy of liver biopsy, studies reporting liver biopsy as a diagnostic tool have been limited due to its invasive nature and high cost