REVIEW article
Front. Endocrinol.
Sec. Renal Endocrinology
This article is part of the Research TopicCardiorenal Metabolic Health and Diabetic Nephropathy: Mechanisms, Biomarkers, and Therapeutic AdvancesView all 7 articles
Traditional Chinese medicine in the treatment of diabetic kidney disease: the mechanisms of signaling pathways regulations
Provisionally accepted
- 1Xiangtan Central Hospital, Xiangtan, China
- 2Changsha Medical University, Changsha, China
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Diabetic kidney disease (DKD) represents a diabetes-driven microvascular complication renal physiological and metabolic disorders, and is considered a top-ranking trigger of progression to end-stage renal disease and death in diabetic patients. Although the drugs commonly used in clinical practice for DKD provide some renal protection, their toxic side effects and limited ability to halt further progression of the disease remain unsatisfactory. Traditional Chinese medicine (TCM) brings centuries of accumulated practice and distinct therapeutic strengths to the management of chronic diseases with complex pathogenesis such as DKD. Its characteristics of multi-target and multi-pathway intervention establish a solid material basis for DKD therapy, while its low toxicity profile aligns well with the chronic nature of DKD. This review elaborates on the therapeutic potential of examining TCM’s impact on DKD through the prism of cellular signaling pathways reveals the Nrf2, TGF-β/Smad, NF-κB/NLRP3, MAPK and PI3K/AKT signaling pathways warrant particular attention in TCM treatment of DKD. The TCM agents involved include Astragaloside IV, Shengqing Jiangzhuo Formula, Huangkui capsule, Fuxin Granules, Liuwei Dihuang Pill, Taxus chinensis, Burdock fructooligosaccharide, Baicalin, Hirudin, rutin and fermented seaweed extracts. This review aims to refresh and consolidate the signaling pathways engaged by TCM in DKD, sift for promising targets and drugs, and supply both conceptual and experimental scaffolding for future anti-DKD therapeutics.
Keywords: Diabetic kidney disease, diabetic nephropathy, Mechanism, signaling pathway, Traditional Chinese Medicine
Received: 20 Jan 2026; Accepted: 05 Feb 2026.
Copyright: © 2026 Li, Lei, Wu, Chen, Liu, Xing, Liu and Zhang. 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:
Xiang Liu
Jiani Zhang
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