# The Role of Non-Coding RNAs in the Pathogenesis and Progression of Diabetic Kidney Disease

## TL;DR

This review explores how non-coding RNAs contribute to diabetic kidney disease and their potential for early diagnosis and treatment.

## Contribution

The paper provides a comprehensive overview of ncRNA roles in DKD and highlights their potential as biomarkers and therapeutic targets.

## Key findings

- ncRNAs regulate key pathological processes like inflammation and fibrosis in DKD.
- Exosomal ncRNAs show promise as non-invasive biomarkers for early detection.
- ncRNA-targeted therapies offer new possibilities for treating DKD.

## Abstract

Diabetic kidney disease (DKD) remains a leading cause of end-stage renal disease worldwide, with current therapies often failing to halt its progression due to an incomplete understanding of intrinsic renal molecular mechanisms. This review highlights the pivotal role of non-coding RNAs (ncRNAs)—including microRNAs (miRNAs), long non-coding RNAs (lncRNAs), and circular RNAs (circRNAs)—as central regulators in the pathogenesis and progression of DKD. We systematically examine how the diabetic milieu dysregulates specific ncRNA profiles in renal cells, driving core pathological processes such as metabolic dysfunction, inflammation, fibrosis, and podocyte injury. Furthermore, we explore the emerging roles of exosomal ncRNAs in intercellular communication and their potential as non-invasive liquid biopsy biomarkers for early diagnosis and disease monitoring. Finally, we discuss the translational prospects of targeting ncRNAs through innovative therapeutic strategies, such as antisense oligonucleotides and miRNA mimics, while addressing the challenges of tissue-specific delivery and clinical implementation. Understanding ncRNA networks offers a refined, systems-level perspective on DKD and opens new avenues for precision diagnostics and targeted interventions aimed at modifying the disease course.