Progression of diabetic nephropathy (DN) is commonly defined by an increase in albuminuria from normoalbuminuria to microalbuminuria and from microalbuminuria to macroalbuminuria. Although many therapeutic interventions, including reducing hyperglycemia and intraglomerular pressure, have been shown to slow down the progression of DN, many patients still develop end-stage renal disease. A major difficulty in inducing remission in patients with early DN is the identification of biomarkers that could help to identify patients more likely to progress to endstage renal disease. Traditional risk factors, such as albuminuria, do not effectively predict DN progression, and other predictors of DN have yet to be characterized and validated. The need for discovering sensitive and robust biomarkers to monitor the decline in renal function and to separate progressors from nonprogressors of DN is therefore of paramount importance.Next to mesangial extracellular matrix deposition and a thickening of basement membranes, progressive loss of glomerular pericytes and "podocytes" and microvascular alterations appear to most closely correlate with the functional renal decline in DN (1-3).Autophagy ("self-eating" in Greek) is a highly regulated lysosomal protein degradation pathway that removes protein aggregates and damaged or excess organelles in order to maintain intracellular homeostasis and cell integrity (4-6). This process was first described in 1957 by Sam Clark Jr. (7), but the term "autophagy" was coined in 1963 by Christian de Duve (8). Autophagy process is well conserved in the evolution from yeast to mammals in various cell types in many organs (9,10). The formation of autophagosomes depends on several genes including Map1lc3B/LC3B, Becn1/Beclin-1, and other autophagy-related (Atg) genes (4). Dysregulation of autophagy is involved in the pathogenesis of a variety of metabolic and age-related diseases (11-17). One caveat of many clinical studies dealing with tissues that should be taken into consideration is that there is a general tendency to extrapolate information regarding the levels of autophagy substrates to the levels of autophagy flux within the tissues. Despite the scarce but compelling literature on the roles of autophagy in the resistance to DN, studies need to determine whether autophagy genes and markers are suitable biomarkers or targets for therapeutic intervention to ameliorate the progression of DN. Future research would ultimately determine the most reliable method for alterations of autophagy related to DN progression, taking ease and quantity of sample acquisition into account.The function of autophagy in the kidneys is currently under investigation, and it has been shown to have a renoprotective effect in several animal models of aging and acute kidney injury, especially in glomeruli (18-21). Importantly, postmitotic podocytes exhibit high levels of basal autophagy as a key regulator of podocyte and glomerular maintenance (22) (Fig. 1).In this issue of Diabetes, Tagawa et al. (23) confirm the protecti...