Pathophysiologic considerations propagating the pro-inflammatory state in CKD include dysregulation of calcium and phosphate, activation of the renin-angiotensin-aldosteron system, NF-ĸB pathways and inflammasome activation related to the accumulation of uremic toxins such as trimethylamine N-oxide, p-cresyl sulfate and indoxyl sulfate derivatives22. Here, REN is linked to chronic kidney disease.