Diabetic Nephropathy in People With Diabetes. Prevalence and Predictive Factors

This study is investigating diabetic kidney disease in people with type 2 diabetes by performing kidney biopsies to better understand why some people develop severe kidney damage and identify factors that predict who is most at risk. **You may be eligible if:** - You are 18 or older with type 2 diabetes - Your kidneys are filtering at a reasonable rate (eGFR above 30) - You have high levels of protein in your urine (a sign of significant kidney damage) - You can give written consent **You may NOT be eligible if:** - You have recently experienced acute kidney failure - You have conditions that make a kidney biopsy unsafe (such as uncontrolled high blood pressure, severe anemia, bleeding risk, or only one functioning kidney) - You have had a previous kidney biopsy or kidney transplant - You are pregnant or planning to become pregnant before the biopsy - You take the blood thinner Marcoumar (phenprocoumon) and cannot safely stop it - You have a very high risk of dangerous blood clots if anticoagulation is paused Talk to your doctor to see if this trial is right for you.