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Despite advances in understanding glomerular pathologies and acute kidney injury, the progression to irreversible renal failure and its associated systemic complications represent a major unresolved challenge. Keratin, a cytoskeletal protein encoded by 54 genes, is now recognized as a pivotal regulator of renal pathophysiology. Emerging evidence implicates keratin dysregulation in renal pathophysiology through dual mechanisms: maintaining podocyte cytoarchitecture via cytoskeletal stabilization and driving fibrosis through aberrant stress\u2010response signaling. These processes position keratin as a molecular mediator bridging structural homeostasis and pathological remodeling in kidney diseases. Current research focuses on its diagnostic potential and therapeutic targeting in chronic kidney disease progression. 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