الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
DM is a major source of worry due to its rising prevalence and associated micro- and macro-vascular consequences, such as kidney failure. Although microalbuminuria has long been thought to be the first sign of DN, non-albuminuric states account for a considerable share of renal impairment.
DM is considered an essential cause of worry due to its rising global prevalence rate, which has resulted in an increase in the incidence of linked micro- and macro-vascular consequences, including kidney failure.
More recently, it has become clear that the renal tubulointerstitium plays a role in the aetiology of DN, with long-term exposure to a number of hemodynamic-and metabolic injuring variables linked to persistent hyperglycemia as contributory factors.
Tubular damage markers have been developed and studied extensively in order to predict the likelihood of acute kidney injury following various nephrotoxic shocks, such as ischemia during heart surgery, infection, and contrast agent delivery. Their role as early markers in patients with chronic renal disease has received little attention.
DN is a prominent microvascular consequence of DM, responsible for 20%–40% of people who require renal replacement therapy. It’s a diffuse process that involves, tubular epithelial cells, glomerular endothelial cells, and the interstitium pathologically. Glomerular hyperfiltration, the silent phase, incipient nephropathy, overt nephropathy, and CKD are all stages of the disease.