title: Diabetic nephropathy in humans: pathologic diversity.
abstract: OBJECTIVE
  Both type 1 and type 2 diabetes are associated with severe complications including diabetic nephropathy. With the rapidly rising number of patients with diabetes worldwide, diabetic nephropathy is becoming one of the most common causes of renal disease. Much research effort is being put into how to identify diabetic nephropathy in patients with diabetes. A considerable number of biomarker studies were recently published on markers in plasma or urine, either with the aim to distinguish patients with or without diabetic nephropathy, or with the aim to predict renal outcome in those patients with diabetic nephropathy. We review the most recent findings on this subject and discuss the lack of histologically proven diabetic nephropathy in the majority of these studies.
  
  
  RESULTS
  Most conspicuous in the field of diabetic nephropathy was the recent identification of a number of biomarkers used either in the diagnosis of diabetic nephropathy or in the evaluation of therapies meant to prevent, slow down, or reverse the processes causing diabetic nephropathy. For the histopathology of diabetic nephropathy, a new classification system was launched in 2010, which will be discussed together with future perspectives.
  
  
  CONCLUSIONS
  Combining histopathological grading of and biomarkers for diabetic nephropathy will further our understanding of this complex disease manifestation.
authors.affiliation: Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Elisabeth J J
authors.initials: EJ
authors.lastname: Valk
authors.forename: Jan A
authors.initials: JA
authors.lastname: Bruijn
authors.forename: Ingeborg M
authors.initials: IM
authors.lastname: Bajema
mesh_terms: D015415:Biomarkers; D024141:Collagen Type IV / Q000652:urine; D003928:Diabetic Nephropathies / Q000175:diagnosis / Q000473:pathology*; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000097:blood; D006801:Humans
chemical_list: D015415:Biomarkers; D024141:Collagen Type IV; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23