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The heme oxygenase-1 pathway. This enzymatic pathway is activated by oxidative stress and is chronically active during a state of insulin resistance. This pathway becomes overwhelmed and unable to become active enough to completely prevent the increasing amount of oxidative damage. Propofol can further activate this enzyme, which reduces oxidative damage and protects the cell. AKI, acute kidney injury; NADPH, nicotinamide adenine dinucleotide phosphate hydrogen.
