complications, is a leading cause of ESRD worldwide. Despite multifactorial interventions such as tight glycemic control, BP control with RAAS blockade and lipid control, which constitute the backbone of the management, most patients continue to show progressive renal damage. Nonenzymatic glycation of proteins represents a major mechanism by which hyperglycemia leads to diabetic renal disease. The identification of novel glycated protein biomarkers in diabetic patients with normoalbuminuria and nephropathy advances our understanding of the physiological perturbations that lead to diabetes and ESRD. A novel therapeutic strategy that could halt the progression of DN should be developed.