Nephroprotective mechanism of Kunkui Baoshen decoction in diabetic kidney disease: Targeting the HERC2/NCOA4-mediated autophagy-dependent ferroptosis pathway

Figure 1 Kunkui Baoshen decoction improves renal function in db/db mice. A: Experimental design and timeline showing db/db mouse model establishment and drug intervention schedule; B-D: Longitudinal monitoring of fasting blood glucose levels, body weight, and urinary albumin-to-creatinine ratio at 4-week intervals during the 12-week treatment period; E: Biochemical assessment after 12 weeks of treatment: Kidney index (kidney weight/body weight ratio); F and G: Liver function markers: Alanine aminotransferase and aspartate aminotransferase; H: Serum creatinine; I: 24-hour urinary total protein; J: Urinary malondialdehyde; K: Kidney injury molecule-1; L: Neutrophil gelatinase-associated lipocalin. UACR: Urinary albumin-to-creatinine ratio; L-KKBS: Low-dose Kunkui Baoshen decoction; H-KKBS: High-dose Kunkui Baoshen decoction; CMC: Carboxymethylcellulose; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; Scr: Serum creatinine; 24hUTP: 24-hour urinary total protein; MALB: Malondialdehyde; KIM-1: Kidney injury molecule-1; NGAL: Neutrophil gelatinase-associated lipocalin. ^aP < 0.05 vs db/m group, ^bP < 0.01 vs db/m group, ^dP < 0.0001 vs db/m group; ^eP < 0.05 vs db/db group, ^fP < 0.01 vs db/db group, ^gP < 0.001 vs db/db group, and ^hP < 0.0001 vs db/db group.