The interaction of hyaluronan with its receptor CD44 has been implicated in pathophysiology of IRI with stimulation of macrophage recruitment by inducing expression of monocyte chemoattractant protein-1 (MCP-1) by the renal tubular cells as well as through promoting renal fibrosis via the transforming growth factor (TGF)-β pathway [122,123,124]. This evidence concerns the gene CCL2 and renal fibrosis.