SIRT1 and diabetic kidney disease: Interestingly, restoration of PT Sirt1 was sufficient to increase pore densities in podocytes and to mitigate albuminuria and worsening of DKD (49), suggesting that PT Sirt1 confers protection in maintaining the glomerular structure and function during the early stages of DKD and that therapeutic agents that increase the renal SIRT1 expression and activity may have a favorable impact in slowing the disease progression of DKD.