PKM and diabetic kidney disease: In addition, pathological PKM2 isoform switching has also been described in renal tubular epithelial cells and endothelial cells of diabetic kidneys, inducing inflammation by regulating intracellular metabolic reprogramming and, eventually, leading to glomerular lesions and renal fibrosis, which promotes DKD progression (Qi W. et al., 2017; Li L. et al., 2020; Liu et al., 2021).