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Hyperlipidemia promotes intracellular lipid accumulation in renal tubular cells, triggering lipotoxicity through mitochondrial dysfunction and endoplasmic reticulum stress ( 2.3 Elevated PKC activity in diabetic kidney disease PKC is a critical mediator of renal injury in DKD ( 2.4 Oxidative stress imbalance in DKD Oxidative stress is a key contributor to renal injury in DKD ( 3 Role of immune cells in the pathogenesis of DKD 3.1 Macrophages Macrophages, which originate from circulating monocytes, are central innate immune cells that polarize into pro-inflammatory M1 or anti-inflammatory/pro-fibrotic M2 phenotypes in response to microenvironmental cues ( In the early stages of DKD, M1 macrophages predominate, secreting pro-inflammatory cytokines and ROS

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