Novel Biomarkers for Early Diagnosis and Progression of Diabetic Nephropathy

Diabetic nephropathy (DN) is one of the most common diabetic microvascular complications and is defined as a rise in urine albumin excretion (UAE) rate and progressive renal function loss. Now albuminuria is considered the gold standard of onset or progression of DN. However albuminuria has certain limitations, clinical practice suggested detectable albuminuria is later than the onset of DN and subsequent intervention could not block the progression of DN effectively, which could lead to renal function deterioration influencing morbidity and mortality. Thus, the request for more reliable highly sensitive and specific biomarkers is needed for early predicting the onset and progression of DN, which is important to slow down or prevent the renal function decline in diabetic patients. Tremendous studies have implicated lots of biomarkers associated with DN could be applied to predict the onset or monitor the progression of DN. In this review, we summarize and screen a lot of already known biomarkers, the newly reported biomarkers in urine and serum,such as serum sKloth, Serum angiopoietin-like protein 2 (Angptl2), and urinary vitamin D-binding protein (VDBP), predicting development and progression of DN, which could be potential useful tools in the management of DN.