Increased sulfamethoxazole accumulation in liver (41.7 μg/kg); microplastics retained in kidneys (3.83%); liver tissue damage (amyloidosis, necrocytosis); increased malonaldehyde (174%) and NF-κβ (104%); decreased antioxidant enzymes (22%); disrupted Keap1–Nrf2 signaling; enhanced oxidative stress and inflammation. Here, KEAP1 is linked to amyloidosis.