SIRT1 and diabetic kidney disease: In addition, SIRT1 can play a protective role in the pathophysiological changes of DKD by regulating the cellular activity under different renal pressures (Zhang et al., 2017), inhibiting the occurrence of oxidative stress in renal tissues (Zhao et al., 2012), and regulating the fibrosis process mediated by the TGF-β/Smad signaling pathway (Ziyadeh, 1993).