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This signaling pathway is essential for the hypertrophic effects of IGF-1.23 Notably, IGF-1 has also been shown to promote intracellular lipid accumulation in mesangial cells, a phenotype similar to foam cells, which leads to reduced contractility in response to angiotensin-II.24,25 Furthermore, kidney samples from patients with advanced CKD and mouse models with renal fibrosis have defective fatty acid oxidation and higher lipid accumulation than controls without fibrosis

On baseline days 5-6, cortisol levels were consistently low during the first half of the scheduled sleep episode and peaked near habitual wake time for baseline days when all participants were entrained to the 24.0-h day (Fig

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