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In the 1980s, the ileal pouchanal anastomosis (IPAA) largely replaced the Kock pouch for patients with UC who required operation and is now the standard procedure for the majority of patients (Figure 16.1)

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Their study, conducted in a rat model of uremia, demonstrated that the encapsulated bacteria effectively reduced elevated plasma urea levels without systemic exposure to the engineered cells, presenting a promising strategy for urea reduction in CKD