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The transmembrane protein nephrin is expressed in renal glomerular podocytes, the visceral epithelial cells that line the outer aspect of the glomerular basement membrane. Altered nephrin production and abnormal podocyte function lead to proteinuria in diseases affecting the glomerulus such as nephrotic syndrome and diabetes. Podocyte injury may be accompanied by shedding of the nephrin protein and/or of podocytes into the urine; studies in experimental animals and in human diabetes support the hypothesis that nephrinuria is a marker for, and may reflect severity of, glomerular filtration dysfunction. ELISA measurement of urinary nephrin may provide an avenue for detection of early renal dysfunction and/or for assessing response to therapeutic interventions in experimental and clinical research.