Rapid growth of diabetes and diabetic kidney disease exerts a great burden on society. Owing to the lack of effective treatments for diabetic kidney disease, treatment relies on drugs that either reduces its progression or involve renal replacement therapies, such as dialysis and kidney transplantation. It is urgent to search for biomarkers for early diagnosis and effective therapy. The discovery of microRNAs had lead to a new era of post-transcriptional regulators of gene expression. Studies from cells, experimental animal models and patients under diabetic conditions demonstrate that expression patterns of microRNAs are altered during the progression of diabetic kidney disease. Functional studies indicate that the ability of microRNAs to bind 3′ untranslated region of messenger RNA not only shows their capability to regulate expression of target genes, but also their therapeutic potential to diabetic kidney disease. The presence of microRNAs in plasma, serum, and urine has been shown to be possible biomarkers in diabetic kidney disease. Therefore, identification of the pathogenic role of microRNAs possesses an important clinical impact in terms of prevention and treatment of progression in diabetic kidney disease because it allows us to design novel and specific therapies and diagnostic tools for diabetic kidney disease. 1. Epidemiology and Diabetes The prevalence of diabetes is rising worldwide and is expected to reach the devastating number of 439 million by the year 2030 from 285 million in 2010 [1]. This huge elevation is attributed to an escalating tendency towards sedentary lifestyle and westernized choice of diet, leading to obesity. Furthermore, the age of onset for the type 2 diabetic patients is showing a trend to begin in youths [2]. Diabetes is a significant public health concern as its rising incidence has greatly increased the cost of treating both diabetes and its numerous debilitating complications. 2. Diabetic Kidney Disease Diabetic kidney disease is one of the diabetic microvascular complications. Type 1 and type 2 diabetes are distinct in etiology and pathogenesis. In spite of different morphological changes of renal injury in type 1 and type 2 diabetic patients [3], type 1 and type 2 diabetic patients have similar risks of renal injury in diseased kidney [4]. The characteristics of diabetic renal injury includes the effacement of podocyte foot processes, gradual mesangial cell (MC) proliferation and hypertrophy, excessive accumulation of extracellular matrix (ECM) proteins, mesangial expansion, and thickening of the glomerular
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