Various distinct studies have reported that early renal tubular damage biomarker levels (including urinary KIM-1 levels) are elevated in patients with diabetes, even in those with normal albuminuria.14-16 This highlights the importance of use of serum KIM-1 from screening perspective of diabetic patient’s for DN during the “tubular phase” of renal damage even before the development of albuminuria. This evidence concerns the gene HAVCR1 and liver dysplastic nodule.