Exosomes in diabetic kidney disease: pathogenesis, biomarker discovery, and emerging therapeutics-a comprehensive systematic review.

In 30 seconds

This comprehensive systematic review examines research on exosomes in diabetic kidney disease (DKD), including their roles in disease mechanisms, biomarker discovery, and potential therapeutic applications. It describes evidence that urinary exosome quantity and composition change under diabetic conditions and may reflect DKD pathology, supporting investigation of exosomes as diagnostic or prognostic liquid-biopsy biomarkers. The review also considers exosomes as drug-delivery vehicles or therapeutic agents. It identifies AI-integrated multi-omics, large-scale multicentre validation, and strategies to address clinical-translation barriers as priorities; the abstract reports no pooled quantitative result.

Key findings

• Urinary exosome quantity and composition change under diabetic conditions, implicating exosomes in DKD pathogenesis.
• Exosomes are being investigated as liquid-biopsy candidates for DKD diagnosis and prognosis.
• Potential therapeutic applications include using exosomes as drug-delivery vehicles and as direct therapeutic agents.
• The review identifies AI-integrated multi-omics and large-scale multicentre trials as priorities for biomarker validation and translation.

Why it matters

Exosomes may connect molecular processes in DKD with measurable signals in urine, offering a potential route to biomarker development alongside investigation of therapeutic delivery. The review also makes clear that these possibilities remain research priorities: understanding exosome heterogeneity and validating biomarker performance in larger multicentre studies are important before clinical translation.

What to keep in mind

The abstract provides no pooled quantitative estimates or specific study-level results, and notes that biomarker efficacy requires large-scale multicentre validation.