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Background: tRNA-derived small RNAs (tsRNAs) are an emerging class of small non-coding RNAs derived from tRNA cleavage. Summary: With the development of high-throughput sequencing, various biological roles of tsRNAs have been gradually revealed, including regulation of mRNA stability, transcription, translation, direct interaction with proteins and as epigenetic factors, etc. Recent studies have shown that tsRNAs are also closely related to renal disease. In clinical acute kidney injury (AKI) patients and pre-clinical AKI models, the production and differential expression of tsRNAs in renal tissue and plasma were observed. Decreased expression of tsRNAs was also found in urine exosomes from chronic kidney disease (CKD) patients. Dysregulation of tsRNAs also appears in models of nephrotic syndrome and patients with lupus nephritis (LN). And specific tsRNAs were found in high glucose model in vitro and in serum of diabetic nephropathy (DN) patients. In addition, tsRNAs were also differentially expressed in patients with kidney cancer and transplantation. Key Messages: In the present review, we have summarized up to date works and reviewed the relationship and possible mechanisms between tsRNAs and kidney diseases.