REVIEW article
Front. Endocrinol.
Sec. Renal Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1580608
This article is part of the Research TopicPathophysiology of Diabetic Kidney DiseaseView all 7 articles
Renal Microcirculation and Mechanisms in Diabetic Kidney Disease
Provisionally accepted
- 1Beijing University of Chinese Medicine, Beijing, China
- 2Institute of Metabolic Diseases, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- 3Guangwai Hospital, Xuanwu, Beijing, China
- 4Changchun University of Chinese Medicine, Changchun, Jilin Province, China
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Diabetic kidney disease (DKD), a severe and long-term complication of diabetes, is a microcirculatory pathology influenced by diabetes-related factors that affects hundreds of millions of people worldwide. DKD is characterized by proteinuria, glomerular injury, and renal fibrosis, ultimately leading to end-stage renal disease. Its pathogenesis is complex and involves multiple cellular and molecular mechanisms. Microcirculatory disorders form the fundamental pathological basis of DKD. These disorders are primarily manifested through changes in the number and structure of renal microvessels, alterations in renal hemodynamics, formation of renal thrombi, glomerular endothelial cell dysfunction, and associated lesions in podocytes and mesangial cells. This article focuses on renal microangiopathy and glomerular endothelial cell (GEC) dysfunction, summarizing the mechanisms associated with microcirculatory lesions in DKD, including nitric oxide (NO), advanced glycation end-products (AGEs), vascular endothelial growth factor (VEGF), the renin-angiotensin-aldosterone system (RAAS), reactive oxygen species (ROS), the NLRP3 inflammasome, protein kinase C (PKC), epidermal growth factor receptor (EGFR), and platelet-derived growth factor (PDGF). Additionally, we briefly introduce the characteristics of DKD animal models in terms of renal microcirculation and discuss the application of relevant technological tools in studying microcirculatory lesions in DKD.
Keywords: Diabetic kidney disease, Renal microcirculation, mechanisms, animal model, Assessment techniques
Received: 20 Feb 2025; Accepted: 05 May 2025.
Copyright: © 2025 Hang, Ma, Wei, Wang, Zang, Xie, Zhang and Zhao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Lili Zhang, Institute of Metabolic Diseases, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
Linhua Zhao, Changchun University of Chinese Medicine, Changchun, 130117, Jilin Province, China
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