The status of studies on the mechanism of microcirculatory dysfunction in the process of diabetic kidney injury

• Published in: Diabetology and metabolic syndrome Vol. 17; no. 1; pp. 154 - 15
• Main Authors: Wu, Zeng, Gao, Yu, Zuo, Chun-yue, Wang, Xiao-rong, Chen, Xiao-han, Zhou, Xiao-hong, Gao, Wei-juan
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 14.05.2025; BioMed Central; BMC
• Subjects: Blood circulation disorders; Chronic kidney failure; Diabetes; Diabetes mellitus; Diabetic nephropathies; Diabetic nephropathy; Disease; End-stage renal disease; Endothelial dysfunction; Endothelium; Energy metabolism; Hemodynamics; Hyperglycemia; Hypoxia; Inflammation; Kidney diseases; Kidneys; Kinases; Metabolism; Microcirculation; Microvasculature; Nephropathy; Pathogenesis; Permeability; Phosphorylation; Renal function; Renal hypoxia; Review; Sapropterin dihydrochloride; Vascular diseases; Endothelial dysfunction; Microcirculation; Diabetic nephropathy; Inflammation; Renal hypoxia
• ISSN: 1758-5996; 1758-5996
• DOI: 10.1186/s13098-025-01718-4

Diabetic nephropathy (DN) is one of the most common and serious microvascular complications of diabetes mellitus (DM) and is the main cause of end-stage renal disease. Endothelial dysfunction caused by persistent hyperglycemia occurs at the initial stage of vascular disease. Moreover, persistent hyperglycemia is also a critical factor causing renal microcirculatory dysfunction. In recent years, many studies have confirmed that chronic hypoxia caused by microcirculatory dysfunction is one of the main mechanisms of kidney injury in patients with DM. Similarly, microcirculatory dysfunction damages renal tissue through interactions with other pathophysiological processes, thereby promoting the occurrence and development of DN. Thus, this article reviews the pathogenesis of renal microcirculatory dysfunction in DM and its interaction with stress, energy metabolism, and immunologic inflammation. Furthermore, a new idea was proposed to analyze the mechanism of kidney injury in DM from the perspective of microcirculatory dysfunction.