The Role of Keratin in the Mechanisms of Kidney Diseases

Kidney disease remains a leading cause of global mortality, with its prevalence continuing to rise. Despite advances in understanding glomerular pathologies and acute kidney injury, the progression to irreversible renal failure and its associated systemic complications represent a major unresolved challenge. Keratin, a cytoskeletal protein encoded by 54 genes, is now recognized as a pivotal regulator of renal pathophysiology. Emerging evidence implicates keratin dysregulation in renal pathophysiology through dual mechanisms: maintaining podocyte cytoarchitecture via cytoskeletal stabilization and driving fibrosis through aberrant stress-response signaling. These processes position keratin as a molecular mediator bridging structural homeostasis and pathological remodeling in kidney diseases. Current research focuses on its diagnostic potential and therapeutic targeting in chronic kidney disease progression. This review synthesizes keratin's multifaceted roles, highlighting its emerging significance in both glomerular and tubulointerstitial pathologies.