Considering the structural changes in diabetic kidney disease, they are similar in both DM1 and DM2, but are more heterogeneous and less predictable in association with clinical presentation in DM2 [23], probably because DM2 has unreliable onset timing, longer exposure to hyperglycemia before diagnosis, older patients, and patients that are treated with renin-angiotensin inhibitors before the onset of diabetes [24]. This evidence concerns the gene REN and diabetic kidney disease.