{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T01:44:44Z","timestamp":1793151884490,"version":"4.5.0"},"reference-count":86,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T00:00:00Z","timestamp":1769040000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National NIH K12 Diabetes-Docs: Physician Scientist Career Development Program","award":["K12DK133995"],"award-info":[{"award-number":["K12DK133995"]}]},{"name":"NIH\/NIDDK","award":["R01DK121019"],"award-info":[{"award-number":["R01DK121019"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Diabetes is the leading cause of end-stage kidney disease and significantly contributes to morbidity and mortality in people with diabetes. Despite significant advances in the last decade, including the development of novel therapies, the residual risk in diabetic kidney disease (DKD) remains high. One yet unaddressed factor in the pathogenesis of DKD is immune activation. Early in DKD, there is infiltration of macrophages, T-cells, B-cells, and dendritic cells in mouse models, while at later stages, neutrophils are also observed. This review will highlight novel insights into the contribution of immune cells to the development of DKD, with a particular focus on the innate immune system and the cellular crosstalk between immune cells and intrinsic kidney cells as contributors to DKD. One example of this bidirectional crosstalk is observed between macrophages and podocytes. While macrophages can directly mediate podocyte injury and apoptosis via TNF-\u03b1 secretion, podocytes secrete cytokines that further recruit macrophages. Understanding the role of immune-mediated injury in kidney disease is critical in reducing the residual risk of DKD.<\/jats:p>","DOI":"10.3390\/ijms27021097","type":"journal-article","created":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T09:16:59Z","timestamp":1769159819000},"page":"1097","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Inflammation and Diabetic Kidney Disease"],"prefix":"10.3390","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5764-4363","authenticated-orcid":false,"given":"Rong Mei","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Metabolism, Medical Specialty Institute, Cleveland Clinic Foundation, Cleveland, OH 44106, USA"},{"name":"Department of Heart, Blood and Kidney Research, Cleveland Clinic Research, Cleveland, OH 44106, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Luiza","family":"Caramori","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Medical Specialty Institute, Cleveland Clinic Foundation, Cleveland, OH 44106, USA"},{"name":"Department of Heart, Blood and Kidney Research, Cleveland Clinic Research, Cleveland, OH 44106, USA"},{"name":"Cleveland Clinic Lerner College of Medicine (CCLCM), Case Western Reserve University (CWRU) School of Medicine, Cleveland, OH 44106, USA"},{"name":"Division of Endocrinology and Diabetes, Department of Medicine, University of Minnesota, Minneapolis, MN 55404, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"883","DOI":"10.2337\/dc18-2062","article-title":"Risk Factors for Kidney Disease in Type 1 Diabetes","volume":"42","author":"Perkins","year":"2019","journal-title":"Diabetes Care"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/j.cegh.2020.05.016","article-title":"Diabetic kidney disease: An overview of prevalence, risk factors, and biomarkers","volume":"9","author":"Hussain","year":"2021","journal-title":"Clin. 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