Sirtuin studies on DKD has reported target proteins including Nuclear factor kappa B (NFκB) (56, 63, 72, 93), Smad3 (65), Smad7 (51), Forkhead Box Protein O1 (FoxO1) (83), Forkhead Box Protein O4 (FoxO4) (55), signal transducer and activator of transcription 3 (STAT3) (63, 93), Peroxsome proliferator-activated receptor-γ coactlvator-1α (PGC1α) (83), p53 (70), and Claudin1 (61). This evidence concerns the gene SMAD3 and diabetic kidney disease.