MMP9 and diabetic kidney disease: The study by Altemtam, Nahas & Johnson (2012), while differing in terms of the inclusion of diabetic kidney disease subjects with macroalbuminuria and at stages 3–4, according to the K/DOQI guide, demonstrated that urinary gelatinase activity attributable to MMP-2 and MMP-9 in DM patients with diabetic kidney disease is 25% greater, compared to that of those with DM alone.