Diabetic kidney disease (DKD) is the leading cause of end-stage renal disease worldwide. Traditional biomarkers such as serum creatinine and estimated glomerular filtration rate lack sensitivity for early kidney injury detection, limiting timely intervention. This review comprehensively evaluates serum biomarkers for DKD, focusing on their diagnostic and prognostic utility, mechanistic insights, and clinical applicability. Novel serum biomarkers, including cystatin C, neutrophil gelatinase-associated lipocalin, kidney injury molecule-1, and tumor necrosis factor receptors (TNFRs) (TNFR1, TNFR2), demonstrate superior sensitivity for early renal damage and progression prediction. Emerging markers, such as adropin, soluble urokinase plasminogen activator receptor, monocyte chemoattractant protein-1, chitinase-3-like protein 1, endostatin, zinc-alpha-2-glycoprotein, PromarkerD, and circulating microRNAs offer additional risk stratification potential. Integrating validated serum biomarkers may enhance early DKD detection, enable precise risk stratification, and support personalized therapeutic strategies to improve patient outcomes.
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Gembillo et al. (2026) studied this question.
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