Given that the potential role of lactate in promoting EMT has been demonstrated in diseases such as myocardial infarction and diabetic nephropathy,12, 13, 14 we hypothesized the involvement of the PDK1 in mediating the EMT of HNECs via lactate under hypoxic conditions and tested this hypothesis using in vitro cultured HNECs. This evidence concerns the gene PDK1 and diabetic kidney disease.