Early detection of diabetic kidney disease: Present limitations and future perspectives

Table 1 Advantages of novel biomarkers in the early diagnosis of diabetic kidney disease

Biomarker	Validation study design	Sample size	Type of diabetes	Specimen	Advantages	Ref.
CysC	CO	52[38]	2	Serum	Not affected by lean body mass	[35-39]
		30[39]			Estimates more accurate than creatinine-based ones when GFR > 60 mL/min per 1.73 m2
NGAL	CC	112	2	Urine	Indicator of glomerular hyperfiltration	[44]
KIM1	CC	112	2	Urine	Indicator of glomerular hyperfiltration	[44]
NAG	CC	434	1	Urine	Baseline level predicts development of DKD	[51]
	CC	946	2			[52]
8-oxodG	PC	396	2	Urine	Baseline level predicts development of DKD	[59]
Pentosidine	CC	434	1	Urine	Baseline level predicts progression of albuminuria	[51]
TNFR1/2	RC	628	1	Serum	Baseline level predicts development of advanced CKD	[65]
	RC	410	2			[66]

CysC: Cystatin C; NGAL: Neutrophil gelatinase-associated lipocalin; KIM1: Kidney injury molecule 1; NAG: N-acetyl-β-(D)-glucosaminidase; 8-oxodG: 8-oxo-7,8-dihydro-2’-deoxyguanosine; TNFR: Tumor necrosis factor receptor; CO: Case-only; CC: Case-control; PC: Prospective cohort; RC: Retrospective cohort; GFR: Glomerular filtration rate; DKD: Diabetic kidney disease; CKD: Chronic kidney disease.