ACTA1 and renal fibrosis: Meanwhile, the EV treatment group had lower levels of BUN (SMD, − 3.60; 95%CI, − 4.25 to − 2.94; P < 0.001), indexes for tubular and endothelial injury, renal fibrosis (fibrosis score and α-SMA), renal inflammation (TNF-α, IL-1β, iNOS, and CD68 + macrophages), but higher levels of indexes for tubular proliferation, angiogenesis-related VEGF, and reactive oxygen species.