B cell–driven Diabetic Kidney Disease uncovered by a high-resolution spatial atlas

Researchers built a cross-platform spatial atlas of diabetic kidney disease using CosMx and Xenium, integrated with snRNA-seq to define 11 tissue niches and injury microenvironments. They identify a B cell–predominant immune microenvironment that defines a DKD subset with faster kidney function decline, and develop tissue biomarkers plus a plasma protein panel that improve risk prediction beyond clinical models; findings validated in UK Biobank and supported by plasma proteomics, highlighting biomarker-guided B cell–targeted DKD trials.