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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

doi: 10.3390/jcm7090258

Kefir peptides (KPs) provide organ-specific protection, including renal and joint tissues, by reducing oxidative stress, suppressing VCAM-1, MCP-1, ET-1, NLRP3, and TGF-, and enhancing antioxidant defenses such as superoxide dismutase (SOD) activity (Chen et al., 2019, 2020)

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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