Insights into predicting diabetic nephropathy using urinary biomarkers

Diabetic nephropathy (DN) is a serious complication of diabetes caused by changes in the structure and function of the kidneys. It is important to detect diagnostic biomarkers of DN at an early stage, in which the drug can slow the loss of kidney function and prevent disease progression. In recent years, a variety of biological markers related to DN have been discovered, which is of great significance for predicting the occurrence and development of diseases. Due to the simplicity of non-invasive collection, urine is an ideal biological sample for the discovery of new biomarkers of kidney disease. We reviewed some new urinary biomarkers related to early DN patients, including urinary proteins, peptides, and exosomes biomarkers. We also highlight the proteins associated with tubular damage, glomerular damage, inflammation and oxidative stress marker. Despite the promise of these new urinary biomarkers, we next proposed a review of the most recent publications reporting on larger cohorts, focusing on those that aim at qualification or validation. This review provides important data to better understand biomarkers related to the pathophysiology of DN, and these markers have been increasingly studied for disease progression to provide effective human treatment. •Comprehensive review the potential urinary protein and peptide biomarkers for diabetic nephropathy.•Exosomes represent a novel and rich source of biomarkers for diabetic nephropathy.•The pathological mechanisms related to these biomarkers were analyzed.