Kidney diseases, characterized by renal dysfunction, are among the leading causes of death worldwide. Preventing and treating kidney diseases is important for reducing their associated morbidity and mortality. Moderate physical exercise has been recognized to be advantageous for kidney health. Irisin is an exercise-induced myokine identified in 2012. It plays an important role in energy and bone metabolism, oxidative stress reduction, anti-inflammatory processes, prevention of cell death, and cardiovascular protection. However, the relationship between irisin and kidney disease has not been fully elucidated. This review explores the role of irisin as a biomarker in the diagnosis of kidney diseases and their associated complications, elucidating the mechanisms through which it participates in various cell death pathways, such as apoptosis, autophagy, pyroptosis and ferroptosis. Furthermore, the levles of irisin secretion are discussed to provide a basis for the preventing and treating kidney diseases, as well as therapeutic guidance for developing new and promising intervention strategies.