It has been reported that other TGR5 agonists both inhibit development of kidney disease in murine models of obesity and diabetes (Wang et al., 2016), and more recently that a TGR5 agonist produced by the gut microbe Bacteroides fragilis can ameliorate renal fibrosis in both unilateral ureteral obstruction and adenine-induced CKD murine models (Zhou et al., 2022). This evidence concerns the gene GPBAR1 and obesity due to melanocortin 4 receptor deficiency.