INS and diabetic kidney disease: It is characterized by decreased insulin action despite elevated blood insulin levels, increasing the risk of cardiovascular events.[29] A recent study showed a role for insulin resistance in renal failure.[30] Insulin resistance plays a role in increasing vascular permeability and is also associated with the development of early glomerular hyperfiltration, contributing to late glomerular injury in the early stages of diabetic nephropathy.[31,32] Insulin signaling plays an important role in renal hemodynamics, podocyte viability, and tubular function.