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In DKD, upregulation of local angiotensin II in the renal tubule, activation of vascular endothelial growth factor (VEGF), and reduction of nitric oxide (NO) (60) can lead to constriction of both the afferent and efferent arterioles, as well as the interlobular arteries, compromising blood flow regulation

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doi: 10.1007/s11356021-130836 38 WHO

It is recommended to start with a series of treatments, once a week for a month, and then move to a maintenance schedule based on your skin's response and your doctor's advice