In diabetic nephropathy drug intervention studies (44), changes in fenestrae-related gene expression patterns suggest different drugs may affect fenestrae structure through different mechanisms: ACEi, as an angiotensin-converting enzyme inhibitor, directly acts on endothelial cells, with its effect on fenestrae formation possibly related to vascular tension regulation (33); rosiglitazone, as a PPARγ agonist, may indirectly regulate fenestrae formation by affecting intracellular lipid metabolism and thereby changing membrane lipid composition. Here, ACE is linked to diabetic kidney disease.