A Nature Communications study by Yu, Hu, Wang and colleagues identified renal insulin‑like growth factor binding protein 7 (IGFBP7) as a molecular driver of progressive diabetic kidney disease (DKD). The team showed that elevated renal IGFBP7 promotes fibrosis and functional decline in diabetic models and provided genetic and pharmacologic loss‑of‑function data that reduce injury metrics. Authors discuss IGFBP7 as both a mechanistic marker and a potential therapeutic target, and they outline translational paths including antibody or RNA‑based inhibition. Kidney disease drug developers and clinical researchers should note the biomarker implications for patient stratification and novel‑target portfolios.