In this context, the sphingomyelinase phosphodiesterase acid-like 3b (SMPDL3b) enzyme was found to play a pertinent role in focal segmental glomerulosclerosis (6) and diabetic nephropathy (7), where SMPDL3b was found to mediate insulin receptor signaling (8). The gene discussed is SMPDL3B; the disease is diabetic kidney disease.