SIRT1 and renal fibrosis: In addition, rhein reduces renal fibrosis by promoting Cpt1a-mediated fatty acid oxidation through the Sirt1/STAT3/twist1 pathway (Chen Y. et al., 2019; Song et al., 2022), thereby leading to an improvement in renal function and reducing interstitial damage and collagen fiber accumulation by activating the Sirt3/FOXO3a pathway (Wu et al., 2020).