Urine peptides enable non-invasive differential diagnosis of nodular diabetic nephropathy
Authors' conclusion
Urinary peptide signatures enable non-invasive discrimination of NDN and predict MAKE, potentially complementing kidney biopsy for subtype identification and risk stratification in DN.
Study context
- Population
- Patients with diabetes and biopsy-proven kidney disease
- Participants
- 43 vs 38
- Comparison
- Nodular diabetic nephropathy (NDN) vs other CKD etiologies in diabetes
- NDNn = 43
- nNDNn = 38reference
- Outcome
- Urinary peptide biomarkers distinguishing NDN from nNDN
Methodological detailsbiopsy-proven, capillary electrophoresis-mass spectrometry, synthetic data augmentation (Gaussian copula), discovery and validation cohorts, support vector machine classifier
- Biopsy-proven
- Capillary electrophoresis-mass spectrometry
- Synthetic data augmentation (Gaussian copula)
- Discovery and validation cohorts
- Support vector machine classifier
Main finding
As reported in the abstract
Discrimination of NDN from nNDN by 99-peptide classifier (NDN99)
Peptides significantly altered (discovery cohort)
207
NDN99 AUC, combined validation
0.87
NDN99 AUC, real-patient validation
0.79
Observational data: associations, not effects.
Further findings
Prediction of major adverse kidney events (MAKE) (death, kidney failure or 40% eGFR loss)
- NDN99, HR
- HR = 2.9, p = 0.0006
- Histology, HR
- HR = 1.9, p = 0.04
- NDN99 outperformed histology
Original publication
Urine peptides enable non-invasive differential diagnosis of nodular diabetic nephropathy. Diabetes Res Clin Pract. Published 26 June 2026. doi:10.
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