Early prediction markers of diabetic nephropathy

A method for identifying risk of developing diabetic nephropathy in a normoalbuminuric diabetic and treating comprising:

• (a) obtaining a urine sample from a normoalbuminuric diabetic subject, wherein the subject is capable of developing microalbuminuria after a physical exercise test,
• (b) measuring the protein expression level of carbonic anhydrase 1 in the urine sample,
• (c) identifying the normoalbuminuric diabetic subject of step (a) at increased risk of developing diabetic nephropathy when the protein expression level of carbonic anhydrase 1 is at least 10% higher than a pre-determined value,
• wherein the predetermined value is a level of the carbonic anhydrase 1 protein measured in a urine sample obtained from a control normoalbuminuric diabetic subject suffering from diabetes and determined not to be at risk for diabetic nephropathy by either absence of microalbuminuria after the physical exercise test or absence of clinical symptoms for at least 2 years;
• and
• (d) administering drugs that lower blood pressure to the identified subject of (c), wherein the drugs are selected from angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs).