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These alterations promote the production of nephrotoxic galactose-deficient IgA1 and exacerbate disease progression [139, 140]

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( 2 ) A QCDR or qualified registry must support all measures and activities included in the MVP with the following exceptions: ( i ) If an MVP is intended for reporting by multiple specialties, a QCDR or a qualified registry are required to report those measures pertinent to the specialty of its MIPS eligible clinicians