The meta-analysis demonstrated that exosome therapy attenuated renal fibrosis, as indicated by reduced fibrosis marker α-SMA (SMD = −2.01, 95% CI: −2.92 to −1.10, P = 0.004; I2 = 0.00%) and decreased fibrosis size (SMD = −3.74, 95% CI: −5.62 to −1.86, P < 0.001; I2 = 0.00%) versus controls (Table 3; Supplementary Figure S6). Here, ACTA1 is linked to renal fibrosis.