ALB and diabetic kidney disease: Most patients progress from microalbuminuria and a normal or high GFR to massive proteinuria and a decrease in GFR.6 Proteinuria indicates podocyte injury, glomerular basement membrane abnormality, and endothelial cell damage,7 and is an important risk factor for the progression of DKD, the occurrence of cardiovascular events, and an increase in all-cause mortality.8–10 Several guidelines recommend mainly determining proteinuria excretion using the urinary albumin-to-creatinine ratio (UACR) of random urine and early screening and treatment to delay the progression of DKD.11