Diabetic nephropathy(DN)is an important complication of diabetes mellitus and an important cause of end-stage renal disease.Patients with DN often have disorders of lipid metabolism.Disorders of lipid metabolism can lead to abnormal distribution of lipids in renal tubules,causing a series of"lipotoxic"phenomena such as renal fat accumulation,lipid droplet accumulation and tubular damage,which in turn induce DN kidney inflammation,fibrosis and other pathological changes.As a high energy-consuming structure in the kidney,lipid metabolic capacity is of great importance to maintain its normal physiological function.The role of lipid energy metabolism on DN and its mechanism of action are described in this paper from cholesterol metabolism-induced DN tubular lipotoxicity,fatty acid metabolism-induced DN tubular lipotoxicity,the role of abnormal lipid metabolism in the"crosstalk"between tubules and glomeruli,and the targeted drug therapy for tubular lipotoxicity,aiming to provide a reference for the new angle and new scheme of clinical prevention and treatment of DN in the future.
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