Introduction Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia resulting from defect in insulin secretion, insulin action or both. The chronic hyperglycemia of diabetes is associated with long term damage, dysfunction and failure of various organs especially the eyes, kidneys, nerves, heart and blood vessels (American Diabetes Association., 2008) Diabetic nephropathy (DN) is one consequences of diabetes and represents an important cause of chronic kidney disease (CKD) Macisaac et al., 2014).~DN is characterized pathophysiologically by an early phase with glomerular hypertrophy, hyperfiltration and microalbuminuria that over the course of years leads to an advanced phase with progressive glomerulosclerosis, rise in the urinary albumin excretion (UAE), and abnormal renal function (Schrijvers et al., 2004).~Conventionally, DN severity is accessed by measuring urine albumin levels (albumin-to-creatinine ratio) persistent microalbuminuria (between 30-300 mg/24 hr) or macroalbuminuria (levels >300 mg/24 hr) is considered a marker and predictor of DN and its progression to ESRD (Adler et al., 2003).~Recent studies are conflicting regarding the sensitivity and the specificity of biomarkers currently used in practice for DN diagnosis. The identification of novel biomarkers of early stages of DN and progression toward ESRD is thus mandatory to reduce the burden of chronic kidney diseases in the human population (Carole et al., 2017).~Uromodulin also called Tamm-Horsfall protein is a 85 kDa glycoprotein normally secreted by epithelial cells lining thick ascending limb (TAL) of Henle's loop and early distal tubule, released by proteolytic cleavage of glycosylphosphatidylinositol (GPI)-anchored protein that is predominant localized to the apical plasma membrane.~. The levels of uromodulin had marked change in urinary excretion in pathological conditions. Therefore, uromodulin was useful as a marker of renal disease (Neng et al., 2017 ).
Diabetes is a major health problem prolonged untreated diabetes cause kidney diseases that can leads to end stage renal disease (ESRD). There are several biomarkers to access the DN severity but there are conflicting regarding the specifity and sensitivity of these biomarkers. So it is important to identify novel biomarker for early detection DN and progression toward ESRD to minimize the prevelance of CKD in human population. Uromodulin is a tubular protein encoded by UMOD gene which expressed predominantly in the epithelial cells of thick ascending limb (TAL) of henel's loop. This study was conducted to evaluate the level of urinary uromodulin and its corresponding gene expression as a potentional marker for early detection of DN in type 2 diabetic patients