Another study found that exogenous supplementation of Klotho or inhibition of miR-199a-5p inhibited the activity of the TLR4/NF-κB p65/neutrophil gelatinase-associated lipocalin (NGAL) signaling pathway and reduced the expression of NGAL, fibrosis factors including FN, connective tissue growth factor (CTGF), and inflammatory factors including MCP-1and CXCL5 in response to high glucose stimulation, effectively attenuated the injury of mesangial cells (MCs), and slowed down the progression of diabetic kidney disease (DKD) to end-stage renal disease (117). This evidence concerns the gene LCN2 and stage 5 chronic kidney disease.