Meanwhile, the higher postoperative CKD stage in patients with E+S+ status as compared to E+S− and E−S+, respectively, can support the potential combined contribution of these molecules in affecting renal function, possibly through the ERG effects presented above, overlapping with SPINK1 involvement in renal MMP12 activation and determining the damage of the interstitial matrix and glomerular basement membrane [48,49]. Here, SPINK1 is linked to chronic kidney disease.