Study of diabetic nephropathy in the proteomic era

Diabetic nephropathy (DN) remains a major complication of diabetes leading to end-stage renal disease (ESRD). The number of diabetic patients with ESRD who require renal replacement therapy has been increasing, implicating unsuccessful prevention of diabetic renal complication. This unfavorable outcome reflects insufficient knowledge on pathogenic mechanisms of DN and its detection at late stage. Currently, microalbuminuria is used for diagnosis of DN. However, some patients with microalbuminuria have advanced renal pathological changes indicating that microalbuminuria is not the perfect marker for early detection of DN and a better biomarker is urgently needed. Recently, particularly after the completion of the Human Genome Project, proteomics (systematic analysis of proteins for their identity, quantity and function) has been recognized as an emerging subdiscipline of modern sciences. During the past decade, proteomics has been widely applied to several areas of biomedical research, including the investigation of DN. This chapter summarizes recent progress of proteomics applied to DN with ultimate goals to better understand its pathogenic mechanisms and to search for novel bio-markers for earlier diagnosis.