The complications of type 2 diabetes are a major global public health problem with high incidence and mortality, affecting almost all individuals with diabetes worldwide. Diabetic kidney disease (DKD) is one such primary complication and has become a leading cause of end-stage renal disease in patients with diabetes. Progression from diabetes to DKD is a complex process typically involving multiple mechanisms. Recent remarkable clinical benefits of sodium–glucose cotransporter 2 (SGLT2) inhibitors in diabetes and DKD highlight the critical impact of renal ion homeostasis on disease progression. This review comprehensively examines the impact of ion homeostasis on the transition from diabetes to DKD, outlining possible therapeutic interventions and addressing the ongoing challenges in this rapidly developing field.

2型糖尿病并发症是全球主要的公共卫生问题，发病率和死亡率很高，影响着全世界几乎所有糖尿病患者。糖尿病肾病（DKD）就是这样的主要并发症之一，并且已成为糖尿病患者终末期肾病的主要原因。从糖尿病进展为 DKD 是一个复杂的过程，通常涉及多种机制。最近钠-葡萄糖协同转运蛋白 2 (SGLT2) 抑制剂在糖尿病和 DKD 中的显着临床益处凸显了肾离子稳态对疾病进展的关键影响。这篇综述全面研究了离子稳态对糖尿病向 DKD 转变的影响，概述了可能的治疗干预措施并解决了这个快速发展领域中持续存在的挑战。