Concurrently, in patients with CKD, the activity of the enzymes catalyzing the first step of the de novo pathway, the conversion of L-Trp to N-formylkynurenine, namely tryptophan 2,3-dioxygenase (TDO) and indoleamine 2,3-dioxygenase (IDO) is increased [29,130], as IDO is known to be sensitive to chronic inflammation, a feature of premature renal aging [131]. The gene discussed is IDO1; the disease is chronic kidney disease.