Lactate and lactylation in the kidneys: Current advances and prospects (Review)

Lactate, traditionally overlooked as a glycolytic byproduct, has recently been recognized for its significant biological roles. The normal kidney plays an essential role in maintaining systemic glucose and lactate homeostasis. Lactylation, as a new epigenetic modification, influences the initiation and progression of kidney diseases through the regulation of gene transcription and cellular metabolism. The present review summarizes current perspectives on the physiological functions of lactate and its renal metabolism, analyzes the roles of lactate and lactylation in acute kidney injury, diabetic nephropathy and chronic kidney disease, and proposes that targeted modulation of lactate metabolism may represent a promising therapeutic strategy for kidney disorders, thereby providing a foundation for future investigations.