Nicotinamide Riboside in Hospitalized Patients

Exclusion Criteria

• •1. Allergy to NR or ingredients in capsules or placebo.
• •2. Patients expected to pass away within 90 days.
• •3. Patients unable to give their consent
• •4. Unstable patients:
• •i. Uncontrolled infection (clinical septicaemia, inadequate response to treatment, inadequate control of source of infection or at treating physician's discretion).
• •ii. Mean arterial pressure \<70 mm Hg and symptoms of hypotension. iii. Patients requiring dialysis at the time of inclusion or glomerular filtration rate \<40 iv. Liver failure with Child-Pugh class B or C or any class associated with hepatic encephalopathy (any grade), alanin aminotransferase or aspartate aminotransferase \>3 times upper limit v. Moderate to severe peripheral oedema and/or pulmonary oedema, any unstable cardiac rhythm, myocardial infarction with peak TNT \>300 past week. Signs of elevated intracranial pressure (headache, vomiting and depressed global consciousness in conjunction with focal neurological signs, papilledema, spontaneous periorbital bruising and a triad of bradycardia, respiratory depression and hypertension).
• •vi. Arterial pH \<7.30 or \>7.50 vii. Serum potassium under 3,2 or over 5 mmol/L.
• •5. Pregnancy or breastfeeding \*
• •6. Any cancer not in full remission for \>10 years
• •7. Use of St John's Wort based supplements during the past 30 days
• •8. Patient has undergone solid organ transplantation
• •9. Participation in any clinical trial with unknown medications
• •10. Major gastrointestinal or other internal bleeding past week
• •11. Logistical challenges after discharge. Patient must be able to attend follow up.
• •12. The treating physician considers the patient unfit or unable to participate. \*All fertile women must have a human chorionic gonadotropin test.