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Hyperglycemia acts as both an initiator of oxidative stress and a co-promoter of pathogenic molecular pathways, and cross-talk among these pathways induces ROS amplification via positive feedback, exacerbating oxidative damage, BRB impairment, iron dyshomeostasis and DR progression (157, 158)

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Plant-dominant low-protein diets (PLADO) can delay DKD progression through multiple mechanisms, including reducing dietary acid load, increasing dietary fiber intake, enhancing gut microbiota diversity, and reducing uremic toxin production (108)

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