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The toxic metabolites retained as a result of altered kidney function contribute to the inflammatory state and drive fibrosis in kidneys, which is why patients with CKD must undergo dialysis

This oxidative damage activates signaling pathways that promote inflammation and fibrosis, leading to glomerular hypertrophy, mesangial expansion, and tubulointerstitial fibrosis [183]

Renal denervation prevents immune cell activation and renal inflammation in angiotensin II-induced hypertension

Finally, we outline future directions within an ethnopharmacological perspective, integrating traditional knowledge with pharmacological innovation to inform multi target, standardized, and potentially personalized interventions for defined ASD endophenotypes