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According to the UK SmPC, these effects are typically dose-dependent and often diminish over time as patients develop tolerance

Some individuals experience kidney-related complications, particularly if they've had previous episodes of nausea, stomach pain, vomiting, or dehydration [11]

The downstream effects most consistently described in the literature: induction of collagen I and III, elastin, and decorin synthesis (Maquart et al., FEBS Letters , 1988), upregulation of VEGF and basic FGF transcripts, induction of antioxidant defense genes including SOD2 and metallothionein isoforms, and modulation of the MMP-2 and TIMP-1/2 balance toward non-fibrotic remodeling

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doi:10.1111/j.1749-6632.2003.tb03167.x Pfaus JG, Sadiq A, Spana C, Clayton AH