(Stefania et al. 2024) Based on these findings and prior studies that have demonstrated the association between NLRP3 inflammasome, Akt, mTOR, and TMAO, (Artlett 2012; Artlett and Thacker 2015; Boini et al. 2017; Zhao et al. 2020; Gallego et al. 2020; Li et al. 2018a, b) the mechanisms underlying the effect of TMAO on renal fibrosis include TMAO binding to and activating PERK, which triggers the Akt/mTOR pathway, which, in turn, promotes cell proliferation and collagen production or regulates NLRP3 and caspase-1 to indirectly promote cell proliferation. Here, AKT1 is linked to renal fibrosis.