AKR1B1 and Hyperglycemia: For instance, in diabetic nephropathy—a progressive kidney disease driven by sustained hyperglycemia and characterized by excessive ECM deposition, mesangial expansion, thickening of the glomerular and tubular basement membranes, and tubulo-interstitial fibrosis [31]—AKR1B1 has been identified as a promoter of EMT and fibrogenesis in tubular epithelial cells.