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Immunol., 41, 161-176 21

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Hyperglycemia in DKD significantly disrupts endothelial permeability, primarily mediated by enhanced oxidative stress, inflammatory factors, and sorbitol production ( Under the conditions of DKD, renal dysfunction leads to an increase in the concentration of nitric oxide inhibitors, disrupting the integrity of the BBB, which in turn contributes to cerebral vascular endothelium injury and cognitive impairment ( Apart from its role in the high-glucose condition, NAA as a neurotransmitter which reflects neuronal damage, is significantly decreased in DKD patients, indicating heightened sensitivity of nerve cells to damage in the context of diabetic renal injury ( Sonoda M et al