The anti-senescence effect of BHB has been reported previously in several models including human aortic smooth muscle cells and mice aorta, where Lamin B1 is elevated and OCT4 mRNA is stabilized via heterogeneous nuclear ribonucleoprotein A1 (hnRNP A1) [17]; in rat cartilage and human osteoarthritic chondrocytes, BHB reduces senescence by PTEN stabilization via hnRNP A1 [18]; in mice diabetic kidney disease, BHB alleviates senescence by reinforcing Nrf2 response via GSK3ß inhibition [72]; and in rat hepatic cells, BHB alleviates senescence via AMPK-mTOR autophagy induction [42]. The gene discussed is POU5F1; the disease is diabetic kidney disease.