In the early stage of DKD, macrophages are recruited and differentiated by inflammatory factors after being stimulated by HG through various signaling pathways (such as phosphatidylinositol 3-kinase (PI3K) / protein kinase B (AKT) and Nuclear Factor kappa-light-chain-enhancer of activated B cells (NF-κB)), and secrete inflammatory and fibrotic factors, resulting in a series of reactions such as activation, polarization, migration and adhesion, transformation, and autophagy, causing fibrosis of intrinsic renal cells and ultimately leading to renal sclerosis and proteinuria30, 38. The gene discussed is NFKB1; the disease is diabetic kidney disease.