Tubular injury in diabetic kidney disease: a focus on regulated cell death

Diabetic kidney disease (DKD), with the high prevalence of diabetes mellitus, has become the primary cause of end-stage renal disease. Tubular injury is one of the earliest characteristic changes and serves as a significant driving factor of renal function loss in DKD. Under physiological conditions, regulated cell death (RCD) preserves renal homeostasis by eliminating damaged tubular epithelial cells. Emerging evidence has demonstrated that abnormal RCD of tubular epithelial cells aggravates the development of DKD. Our review intends to elucidate recent discoveries regarding the pathogenetic role of the most studied RCD, such as apoptosis, necroptosis, pyroptosis, ferroptosis and autophagy, in DKD, and provide a theoretical foundation for future investigations as well as targeted drug design.