Diabetic Nephropathy; Over view and use of Urinary Fetuin-A Diagnostic and Prognostic Marker
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Abstract
Type 2 diabetes mellitus (DM) is the most common type of diabetes, accounting for around 90% of all cases of diabetes.Diabetic nephropathy (DN) is the largest single cause of end-stage kidney disease, therefore, there is an urgent need to identify more sensitive and specific biomarkers than microalbuminuria for early detection of DN. Diabetic nephropathy is one of the most common secondary complications of diabetes mellitus and is becoming a major cause of morbidity and mortality among diabetic patients .It isa microvascular complication occurring in approximately 20-40% of patients with type 2 diabetes mellitus (T2DM), is characterized by the progressive impairment of glomerular filtration and the development of Kimmelstiel-Wilson lesions leading to end-stage renal disease (ESRD).There are many markers that may be more sensitive than urinary albumin, (the current gold Standard, in the detection of incipient nephropathy and risk Assessment of cardiovascular disease); however, the sensitivity of these markers compared with albumin requires further investigation.It is believed that elevated circulating concentrations of fetuin-A may be a risk factor for conditions such as type 2 diabetes mellitus, metabolic syndrome and non-alcoholic fatty liver disease.