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Review Article

J App Pharm Sci. 2026; 16(3): 92-104


The Role of NADPH Oxidase in Diabetic Kidney Disease: Mechanisms, Isoforms, and Therapeutic Opportunities

Shilna Muttickal Swaminathan,Shankar Prasad Nagaraju,Mohan V Bhojaraja,Indu Ramachandra Rao,Ravindra Prabhu Attur,Dharshan Rangaswamy,Srinivas Vinayak Shenoy,Ankur Gupta,Kirthinath Ballala,Sindhura Lakshmi Koulmane Laxminarayana.



Abstract
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Diabetic kidney disease (DKD) is a long-term complication of diabetes mellitus, significantly contributing to morbidity and mortality. In the multifactorial pathogenesis of DKD, NADPH oxidase (Nox) has recently been identified as a pivotal player in both the initiation and progression of disease. Nox enzymes are key producers of reactive oxygen species (ROS), perpetuating oxidative stress, which serves as a major trigger for renal cell injury. Thus, it is imperative to assess the precise role of Nox-mediated oxidative stress and distinct Nox isoforms involved in DKD. Our review provides insights into the intricate mechanisms through which Nox and its subtypes contribute to the pathogenesis of DKD, emphasizing its involvement in glomerular (podocyte, mesangial, endothelial) and tubular injury, as well as subsequent interstitial inflammation and fibrosis. Additionally, we have summarized emerging therapeutic strategies targeting Nox inhibition to mitigate the progression of DKD, which offers focused clinical interventions for improved patient outcomes

Key words: Diabetic Kidney Disease, NADPH oxidases, ROS, Oxidative stress, Proteinuria







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