Diabetic Kidney Disease: A Versatile Disease

Diabetic kidney disease (DKD) is a microvascular complication of diabetes characterized by elevated urine albumin excretion, a decrease in the glomerular filtration rate (GFR), or both. Type 2 diabetes (T2D) accounts for approximately 20%–40% of DKD cases. There are two main risk factors for progression to DKD: modifiable and nonmodifiable. Modifiable factors include hyperglycemia, a long duration of diabetes, a sedentary lifestyle, high blood pressure, obesity, metabolic syndrome, smoking, and dyslipidemia. Nonmodifiable factors include ethnicity, age, genetics, and sex. For many decades, albuminuria was considered the main clinical sign of DKD; however, many patients with diabetes do not follow the classic course of DKD. Approximately 9.0%-39.0% of patients with diabetes and a GFR < 60 mL/min/1.73 m2 do not present albuminuria. In this context, the effectiveness of diagnosis and early treatment for DKD is limited by the lack of accessible and safe biomarkers with high sensitivity. Hence, there is an urgent need to identify biomarkers to diagnose and monitor DKD. The use of different omics technologies can be helpful.

Keywords: DKD (Diabetic Kidney Disease), Diabetic nephropathy, Microvascular complication, Type 2 diabetes, Type 1 diabetes.