The incidence of diabetic nephropathy (DN) is constantly rising in parallel with the prevalence of type 2 diabetes and has been predicted to double within the next 15 years. Albuminuria is considered the earliest putative diagnostic sign of diabetic renal damage but it is poorly associated to the complex histopathological picture of glomerular and tubular damage hence, up to now, the accurate diagnosis of the DN requires renal biopsy. The identification of new biomarkers of DN is an urgent need since the proper management of the DN patients requires early and unbiased diagnosis. The Proteomics approach to the study of the human disease allows a large-scale characterisation of the protein content of a biological sample, and its application to urine may be a challenging but powerful strategy to identify new DN biomarkers. In this review we discuss the main results of a decade of proteomic studies focused on the urinary investigation of diabetic nephropathy.
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