NSA2 is a nucleolar protein essential for 60S ribosomal subunit biogenesis and protein synthesis. Mechanistically, NSA2 localizes to the nucleolus through nucleolar localization signals and is required for maturation of 5.8S and 25S ribosomal RNA 1, functioning as a partner of the GTPase Nog1 in pre-60S particle assembly 1. NSA2 depletion reduces rRNA synthesis rates and suppresses global protein synthesis while inactivating mTOR signaling 2. Beyond ribosome biogenesis, NSA2 regulates cell proliferation and G1/S cell cycle transition 3. In disease contexts, NSA2 expression is dysregulated in chr5 kidney disease and diabetic nephropathy, where it is hyperglycemia-induced and co-regulated with mitochondrial ribosomal factor GFM2 4. In renal cells, NSA2 predominantly localizes to the cytosol and translocates to the nucleus upon TGFβ1 stimulation, acting upstream of TGFβ1 pathway signaling and fibronectin expression 5. In cancer contexts, NSA2 expression correlates with colon adenocarcinoma progression 6, and NSA2 destabilization by novel camptothecin derivatives induces p53-dependent apoptosis in non-small cell lung cancer 7. These findings establish NSA2 as a multifunctional factor linking ribosomal biogenesis to cell proliferation, metabolic regulation, and pathological responses in kidney and cancer diseases.