Based on these observations—which indicate the pivotal role of the TGF-β regulated EndoMT pathway in renal fibrosis—we will focus on the molecular mechanism of ESM1-induced EndoMT procedure of renal fibrosis, predicting the possibility for ESM1 as an up- or downstream target protein of TGF-β/Smad or MAPKs signaling pathway, and ESM1 could be an important target for renal fibrosis therapies in the future. Here, TGFB1 is linked to renal fibrosis.