Novel biomarkers of diabetic kidney disease in type 1 diabetes

Diabetic kidney disease is a complication of inadequately controlled diabetes of any type. It is the main reason for end-stage renal disease and the need to start dialysis, leading to a great burden for health care systems. Moreover, it strongly diminishes the quality of life and shortens life expectancy. The pathophysiology, diagnostics and treatment methods of diabetic kidney disease are not yet fully understood. This complication is underestimated and most often diagnosed in an advanced stage of renal deterioration. However, the sooner the disease is detected, the better the chance to slow down its progression. Patients with type 1 diabetes are especially vulnerable to the development of diabetic kidney disease mainly because they become diabetic in their early childhood. So, it seems to be extremely important to prevent kidney damage in these patients, or at least to diagnose this complication as soon as possible and to undertake appropriate medical intervention. In this article, we describe the current state of knowledge about diabetic kidney disease and its diagnostics. We also propose new biomarkers for the early recognition of diabetic kidney disease in patients with type 1 diabetes. These biomarkers appear to have very promising properties: they are detectable in blood and/or urine samples earlier than traditional markers, and they also seem to be more sensitive and specific biomarkers of diabetic kidney disease.