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Elevated phosphate activates RUNX2 in VSMCs, promoting calcium-phosphate deposition and arterial stiffening ( Figure 1 delineates the dysregulated mineral metabolism axis in CKD, wherein FGF-23 induces parathyroid hyperplasia and downregulates calcium-sensing receptors (CaSR), abrogating calcium-mediated suppression of PTH secretion ( FIGURE 1 3 CKD-associated immune dysregulation 3.1 Chronic inflammation and oxidative stress Chronic kidney disease is marked by a persistent state of low-grade inflammation, a critical factor driving disease progression and its associated complications, such as cardiovascular disease (CVD) ( Oxidative stress, another defining feature of CKD, significantly amplifies this inflammatory milieu and impairs immune function

The mRNA expression of MMP13 in the GH@LM group was significantly lower than that in the PBS and GH groups, while the expression of Col II and Aggrecan was significantly greater in this group (Fig

20 (19), E4961