Nrf2 signaling has also been implicated in the pathogenesis of other diabetic complications, such as diabetic nephropathy: hyperglycemia increases the production of ROS, activating several downstream signaling pathways in glomerular mesangium, inducing inflammation and proliferation that cause hypertrophy of the mesangium, extracellular matrix protein accumulation and glomerular atrophy [24]. This evidence concerns the gene NFE2L2 and diabetic kidney disease.