REN and endothelial dysfunction: It also activates the renin-angiotensin system, leading to renal vasoconstriction, endothelial dysfunction, and vascular smooth muscle proliferation.26 These processes contribute to vascular remodeling, resulting in glomerulosclerosis and interstitial fibrosis.27 In a study of patients with lupus nephritis, those with high SUA levels compared with those with low SUA levels exhibited more crescents, a higher degree of mesangial matrix, increased endothelial cell proliferation, and more inflammatory cell infiltration.28