As compared to DKD patients with stable kidney function during the follow-up period, tubular expression levels of ACSL4 at baseline were significantly higher in the DKD patients with rapid kidney function decline (0.27 ± 0.03 vs. 0.30 ± 0.04, p = 0.002), indicating it could be an early marker of future kidney function decline. This evidence concerns the gene ACSL4 and diabetic kidney disease.