The lactate-lactylation axis in renal fibrosis: potential mechanisms in diabetic kidney disease

The lactate-lactylation axis is closely associated with renal fibrosis progression in DKD, and targeting this axis offers a promising therapeutic strategy to potentially slow fibrosis and preserve renal function in DKD. Consequently, inhibiting lactate dehydrogenase A, modulating monocarboxylate transporters, or targeting lactylation enzymes may provide novel treatment avenues. However, current evidence remains largely correlative, underscoring the need for large-scale cohort studies and early-phase clinical trials to validate its translational potential.