PDC and chronic kidney disease: In a more general context of persistent HIF-α induction, this mechanistic model may explain the dual effect of PHD inhibition in the development of chronic kidney disease (CKD), depending on the timing of the administration: deleterious by an early treatment, when HIF-α signaling contributes to the pathological response to a metabolic stressor; beneficial by a late treatment, when the response to hypoxia is impaired [134].