Background Diabetic nephropathy (DN) is one of the most serious complications of diabetes mellitus (DM) that often results in end-stage renal disease (ESRD). The global DM epidemic has made DN a public and clinical medical concern. It was shown that the age-standardized DN global prevalence was 15.48/1000 among men while in women was 16.50/1000. In Egypt, hypertension followed by DM are the primary causes of ESRD. Cross-sectional and longitudinal investigations revealed hyperglycemia, age, male gender, race, genetic susceptibility, hypertension, hyperfiltration, and smoking as DN risk factors. The earliest DN clinical evidence is microalbuminuria. Since structural damage could increase albumin excretion, there are several limitations to its diagnostic efficacy. Thus, specific and sensitive DN biomarkers are requried. The pathogenesis of DN is complex and poorly understood, resulting in poor treatment outcomes. The treatment of DN includes glycemic management, hypertension and hyperlipidemia treatment, protein restriction, and renal replacement therapy. Understanding the pathogenic mechanisms of DN is crucial for the development of new DN treatments. Aim of the Review The review aims to empower researchers with a comprehensive and contemporary understanding of DN, facilitating early risk stratification, timely diagnosis, and the development of more effective and targeted therapeutic interventions.
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