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The incremental benefit beyond established risk markers must be rigorously demonstrated in prospective studies before widespread adoption ( Ultimately, while these technologies represent breakthroughs in DKD risk prediction and early detection, their clinical success hinges on overcoming challenges related to generalizability, bias, interpretability, and regulatory approval

Acknowledgements This research was partially supported by NSF grants DMS-0616710(MR, HFN) and EF-1038593(HFN, MR) and NIH grant R01 ES019876 (D

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