NFE2L2 and Nephropathy: Results from multiple studies highlight the critical role of Nrf2 in kidney disease.88, 89, 90, 91 A recent systematic review of 32 studies concludes that whereas Nrf2 expression was consistently downregulated in CKD, NQO1, and HO-1 showed varying alterations related to inflammation, comorbidities, and severity of kidney damage.92