ANGPTL4 and diabetic kidney disease: Podocytes likely have a less active sialic acid biosynthesis pathway (Chugh et al., 2012), and in the setting of severe upregulation of Angptl4 in MCD and diabetic nephropathy, this pathway is unable to cope with high demand, despite a slight increase in the expression of the rate limiting enzyme GlcNAc 2-epimerase (GNE) in both disorders.