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doi: 10.3389/fendo.2019.00155 96 ChristouGAKatsikiNBlundellJFruhbeckGKiortsisDN

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This is consistent with established clinical guidance, including FDA recommendations and psychiatric practice guidelines, which emphasize immediate mental-health evaluation when suicidal ideation or significant psychological distress is present

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In addition to oxidative stress, local inflammation mediated by proinflammatory cytokines, such as interleukin6 (IL-6), tumor necrosis factor-alpha (TNF-), IL-18, can cause direct damage to the renal cells and can lead fibrosis via extracellular matrix accumulation