Diabetic kidney disease, or kidney disease attributed to diabetes, occurs in 20–40% of patients with diabetes and is the leading cause of end-stage renal disease (ESRD). Diabetic nephropathy is a clinical syndrome characterized by the persistent albuminuria (>300mg/day or >200μg/min) that is confirmed on at least 2 occasions 3-6 months apart, progressive decline in the glomerular filtration rate (GFR) and elevated arterial blood pressure (> 130/90). Diabetic nephropathy is the leading cause of chronic kidney disease in the United States and other Western societies. It is also one of the most major long-term complications in terms of morbidity and mortality for individual patients with diabetes. Diabetes is responsible for 30-40% of all end-stage renal disease (ESRD) cases in the United States.Recent researches indicate that increased plasma level of Lp- PLA2 is associated with incidence and development of DKD in T2D patients. Lipoproteinassociated phospholipase A2 (Lp-PLA2) is a proinflammatory enzyme that has been confirmed to be independently associated with atherosclerosis .Lipoprotein-associated phospholipase A2 (Lp-PLA2) is a proinflammatory enzyme that has been confirmed to be independently associated with atherosclerosis and the plasma Lp-PLA2 is a marker for inflammation in the vessel wall. Considering the potential proinflammatory effect of Lp‐PLA2, a number of studies were carried out to determine the role of this enzyme in DR. A recent epidemiologic study showed that the activity of plasma Lp‐ PLA2 is higher in diabetic patients with Proliferative diabetic retinopathy than in healthy individuals and diabetic patients with non- proliferative diabetic retinopathy. In addition, the increase in Lp‐ PLA2 was correlated with the severity of diabetic retinopathy.Several studies indicated that atherosclerosis and endothelial dysfunction, which are related to inflammation caused by hyperglycemia, were also involved in DKD, as well as macrovascular complications. Lipoproteinassociated phospholipase A2 (Lp-PLA2) is a pro- inflammatory enzyme that has been confirmed to be independently associated with atherosclerosis.

Lipoprotein-associated phospholipase- A2, Diabetic Kidney Disease