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Despite improved metabolic and blood pressure control, DKD prevalence continues to increase, creating major clinical and socioeconomic burden. Non-coding RNAs, especially microRNAs (miRNAs), regulate DKD development and progression through cell-type specific dysregulation that drives podocyte loss, EMT, endothelial dysfunction, and interstitial fibrosis. Circulating and urinary miRNAs also serve as stable non-invasive biomarkers reflecting renal injury. The review consolidates recent cell-specific miRNA network discoveries and emphasizes diagnostic and therapeutic potential for precision management.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/mirna-in-the-progression-of-diabetic-kidney-disease-new-insight/462236/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/mirna-in-the-progression-of-diabetic-kidney-disease-new-insight/462236.png","ImageObject",300,407,{"name":92,"@type":93},"Jacob","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":29},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What makes diabetic kidney disease a major global health problem?","Question",{"text":112,"@type":113},"DKD is a frequent microvascular complication of diabetes and remains a leading cause of end-stage renal disease worldwide. Even with advances in metabolic and blood pressure control, its prevalence keeps rising, increasing clinical and socioeconomic burden.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How do microRNAs contribute to DKD progression?",{"text":117,"@type":113},"The review explains that miRNAs modulate gene expression by binding target mRNA 3′-UTRs, affecting processes such as ECM turnover, EMT, inflammation, and apoptosis. Dysregulated miRNA patterns in specific renal cells drive injuries including podocyte loss, tubular EMT, endothelial dysfunction, and interstitial fibrosis.",{"name":119,"@type":110,"acceptedAnswer":120},"Which miRNAs are highlighted as promoting or protecting DKD-related pathways?",{"text":121,"@type":113},"The text notes that profibrotic miRNAs such as miR-21, miR-192, and miR-214 reinforce TGF-β/Smad signaling. Protective miRNAs, including miR-29 and miR-30 families, help maintain epithelial stability and limit matrix deposition.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},462236,1791159952,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":29,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},962084931830,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","Review  \nmiRNA in the Progression of Diabetic Kidney Disease: New Insight  \nZhiyue Zou, Ning Zhou  and Chun Zhang *  \nAcademic Editor: Kota V. Ramana  \nReceived: 8 November 2025  \nRevised: 23 December 2025  \nAccepted: 25 December 2025  \nPublished: 31 December 2025  \nCopyright: © 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.  \nDepartment of Nephrology, Union Hospital, Tongji Medical College, Huazhong University of Science and  \nTechnology, Wuhan 430022, China; [zouzhiyue@hust.edu.cn](zouzhiyue@hust.edu.cn) (Z.Z.); [nzhou2527@126.com](nzhou2527@126.com) (N.Z.)  \n* Correspondence: [drzhangchun@hust.edu.cn](drzhangchun@hust.edu.cn)  \nAbstract  \nDiabetic kidney disease (DKD) is a major microvascular complication of diabetes and a leading cause of end-stage renal disease worldwide. Despite advances in metabolic and blood pressure control, the prevalence of DKD continues to rise, creating a significant clinical and socioeconomic burden. Recent studies have revealed that non-coding RNAs, particularly microRNAs (miRNAs), play an important role in the development and progression of DKD. Distinct patterns of miRNA dysregulation have been identified in specific renal cell types, including podocytes, mesangial cells, tubular epithelial cells, endothelial cells, fibroblasts, and macrophages. These alterations drive characteristic cellular injuries such as podocyte loss, mesangial matrix expansion, tubular epithelial–mesenchymal transition, endothelial dysfunction, and interstitial fibrosis. Certain miRNAs, such as miR-21, miR-192, and miR-214, reinforce profibrotic TGF-β/Smad signaling, whereas protective groups, including the miR-29 and miR-30 families, maintain epithelial stability and restrict matrix deposition. Beyond their regulatory roles, circulating and urinary miRNAs have emerged as stable, non-invasive biomarkers that reflect renal injury and disease progression. This review summarizes recent progress in elucidating cell-specific miRNA networks in DKD and highlights their potential as diagnostic indicators and therapeutic targets for precision management of diabetic kidney disease.  \nKeywords: miRNA; diabetic kidney disease; biomarker  \n1. Introduction  \nDiabetic kidney disease (DKD), also known as diabetic nephropathy (DN), represents one of the most prevalent and severe microvascular complications of diabetes mellitus and remains a leading cause of end-stage kidney disease (ESKD) worldwide. Despite advancesin glycemic and blood pressure control, the incidence of DKD continues to rise globally, imposing a significant socioeconomic and public health burden. Epidemiological studies estimate that approximately 20–40% of patients with diabetes eventually develop kidney impairment during the course of the disease [1] . Many of these ultimately progress to ESKD, requiring renal replacement therapy such as dialysis or kidney transplantation, which markedly reduces quality of life and increases mortality [2] .  \nIn China, the rapid increase in the diabetes prevalence has altered the etiologic landscape of chronic kidney disease (CKD) . Diabetes has now surpassed glomerulonephritis asthe most common cause of CKD, and its contribution to incident ESKD has markedly increased in the past two decades [3] . Recent nationwide surveys have shown that  \napproximately one-third of Chinese adults with diabetes exhibit diabetic CKD [3], including a 30.8% prevalence of albuminuria, and a 5.5% prevalence of reduced eGFR (\u003C60 mL/min/1.73 m2 ) [4] . These findings underscore the growing economic public health burden of DKD in Asian populations and emphasize the urgent need for earlier detection and mechanism-based interventions.  \nTraditionally, DKD pathogenesis has been attributed to metabolic and hemodynamic factors—including chronic hyperglycemia, hypertension, oxidative stress, and inflammation—that lead to","cbCaiqH7FkNe3O6W","https://ap.wps.com/l/cbCaiqH7FkNe3O6W","pdf",1418568,22,"English","# Introduction\n## DKD burden and epidemiology\n## Traditional pathogenesis and limitations\n## Role of microRNAs in DKD","[{\"question\":\"What makes diabetic kidney disease a major global health problem?\",\"answer\":\"DKD is a frequent microvascular complication of diabetes and remains a leading cause of end-stage renal disease worldwide. Even with advances in metabolic and blood pressure control, its prevalence keeps rising, increasing clinical and socioeconomic burden.\"},{\"question\":\"How do microRNAs contribute to DKD progression?\",\"answer\":\"The review explains that miRNAs modulate gene expression by binding target mRNA 3′-UTRs, affecting processes such as ECM turnover, EMT, inflammation, and apoptosis. Dysregulated miRNA patterns in specific renal cells drive injuries including podocyte loss, tubular EMT, endothelial dysfunction, and interstitial fibrosis.\"},{\"question\":\"Which miRNAs are highlighted as promoting or protecting DKD-related pathways?\",\"answer\":\"The text notes that profibrotic miRNAs such as miR-21, miR-192, and miR-214 reinforce TGF-β/Smad signaling. Protective miRNAs, including miR-29 and miR-30 families, help maintain epithelial stability and limit matrix deposition.\"}]","miRNA in the Progression of Diabetic Kidney Disease: New Insight | PDF",1790763673,55]