Diagnostic Value of Sensitive Biomarkers for Early Kidney Damage in Diabetic Patients with Normoalbuminuria

To the Editor: Diabetic kidney disease (DKD) is the most common cause of end-stage renal disease (ESRD); however, the onset of DKD is difficult to detect. Some studies demonstrated that vesicles from the apical cell surface are shed into urine with podocyte biomarkers and provided evidence for this phenomenon in diabetic patients by demonstrating the presence of vesicles in urine using immunoelectron microscopy and immunofluorescence. ROC analysis showed that the AUC values for podocalyxin, nephrin, NGAL, and KIM-1 were >0.7. [...]our findings indicate that these markers may have potential clinical applications in the early identification of high-risk individuals, thereby allowing the initiation of early treatment and the prevention or delay of DKD.