sGC modulators enhance the NO–sGC–cGMP pathway, improving vascular function and exerting anti-inflammatory, antifibrotic, and antioxidant effects in DKD, but primarily target downstream mechanisms (e.g. proteinuria, renal fibrosis) rather than upstream drivers like hyperglycemia, necessitating adjunct use with RAAS/SGLT2 inhibitors for synergistic benefits [11]. This evidence concerns the gene SGCB and diabetic kidney disease.