الفهرس 
Review Of LiteratureOnly 14 pages are availabe for public view
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Abstract
Diabetes mellitus is considered an important clinical problem throughout the world International Diabetes Federation, (2013).
The increasing number of diabetic patients has a major impact on the prevalence of diabetic nephropathy de Boer et al., (2011). Diabetic nephropathy, which occurs in 20% to 40% of all patients with type 2 diabetes mellitus Tuttle et al., (2014), is a metabolic disorder with high morbidity and mortality and is the leading cause of end-stage renal disease (ESRD) (Collins et al., 2012).
Microalbuminuria is the most popular method for detecting the early signs of diabetic nephropathy Mora-Fernández, (2014). However, pathological changes have been reported to occur before the onset of microalbuminuria (Fioretto P et al., 2007).
Interestingly, in chronic cases of diabetic nephropathy, kidney function correlates best with the degree of tubulointerstitial injury rather than with glomerular lesions, suggesting that researchers should look for tubular biomarkers in order to identify patients with diabetic nephropathy (Thomas et al., 2005).
So, there is a need for detecting another biomarkers that might provide a sensitive and fast means for identification of the progression of diabetic nephropathy. In this regard, biomarkers that reflect tubular damage have been proposed by various investigators (Tramonti et al, 2013).
Early diagnosis of DN before advanced renal damage is obviously an important goal; this goal is difficult because most of renal structural injury can occur in absolute clinical silence. Current practice does not allow for routine kidney biopsies because of its invasive nature.