In CKD, the lack of key genes such as acyl-Coenzyme A oxidase (Acox) and phosphoenolpyruvate carboxy kinase (PCK) for fatty acid β-oxidation can directly induce ATP depletion, apoptosis, and lipid accumulation ultimately lead to epithelial-mesenchymal transition (EMT) and renal fibrosis [28, 29]. The gene discussed is ACOX1; the disease is renal fibrosis.