Therefore, as the metabolic mechanism of myocardial lipid peroxidation based on renal insufficiency remains unclear, and no studies have explored the specific role of CSNO in this regard, we propose that the ACAA2 protein exerts a protective role against myocardial lipid peroxidation in renal dysfunction and that CSNO participates in protecting against cardiac dysfunction under renal insufficiency through the FOXO4–ACAA2 axis. This evidence concerns the gene FOXO4 and Renal insufficiency.