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TCM also mitigates subjective symptoms (fatigue, edema) unaddressed by conventional therapies and poses lower risks of hypotension/electrolyte disorders, even in advanced CKD ( 4.2 Nutrient-sensing mechanisms: Key players in DKD pathogenesis While malnutrition is indeed a secondary manifestation of metabolic and renal dysfunction, nutrient sensing dysregulation (e.g., via AMPK/SIRT1/mTORC1 pathways) constitutes a pivotal mechanism in DKD progression, deeply intertwined with oxidative stress and autophagy impairment

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4.1.3 Ferroptosis suppressor protein 1(FSP1) -coenzyme Q10 (CoQ10)-NADPH pathway The FSP1-CoQ10-NAD(P)H pathway is crucial in ferroptosis prevention, alongside the GPX4 pathway, the main defense mechanism

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Bahrambeigi V , Lee JJ, Branchi V, Rajapakshe KI, Xu Z, Kui N, Henry JT, Kun W, Stephens BM, Dhebat S, Hurd MW, Sun R, Yang P, Ruppin E, Wang W, Kopetz S , Maitra A, Guerrero PA

Sandeep Kumar Barodia, The University of Alabama at Birmingham, United States Updates Copyright 2018 Allen, Romay-Tallon, Brymer, Caruncho and Kalynchuk