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Diabetic Nephropathy: A New Era in Diagnosis and Treatment

Introduction

Diabetic nephropathy (DN), a common microvascular

complication of diabetes, remains the leading cause of end-stage renal disease (ESRD) globally. While traditionally viewed as a progressive condition characterized by albuminuria and declining renal function, recent research has revealed new patterns of disease progression, novel biomarkers, and promising therapeutic interventions. This article explores the evolving landscape of DN and how it is reshaping clinical practice.

1. Beyond Albuminuria: A Shift in Diagnostic Paradigm

For decades, microalbuminuria was the hallmark of early DN. However, up to 30% of diabetic patients with reduced glomerular filtration rate (GFR) may present without significant proteinuria. This "non-proteinuric diabetic kidney disease" is emerging as a distinct phenotype, challenging the conventional diagnostic criteria.