 Diabetes mellitus is a global epidemic affecting over 346 million people worldwide. It is projected to become the seventh leading cause of death by 2030, and its complications such as chronic kidney disease, CKD, can lead to end-stage renal disease, ESRD. CKD is the leading cause of ESRD in the United States, and diabetes is an independent and strong risk factor for ESRD due to other causes, such as hypertensive nephropathy. Despite this, urinary albumin levels are still used to predict the development and progression of diabetic nephropathy. New markers are being researched, but current progress suggests that the use of urinary albumin levels may continue for some time. This article was authored by Bijan Roshan and Robert C. Stanton.