In type 2 diabetes, the progressive nature of diabetic kidney disease (DKD) induces high risk of morbidity and mortality. The aim of our study was to assess the predictive value of serum intercellular adhesion molecule 1 (ICAM 1) for the increasing of albuminuria in early stages of type 2 DKD. Consecutive type 2 diabetic patients with a one year followed up were included in this study. Outcome measurement for assessing the progression of diabetic kidney disease was the change in urinary albumin to creatinine ratio (ΔuACR). 93 type 2 diabetic patients were enrolled in the study, of which 58 were normoalbuminuric and 35 patients were albuminuric. Their mean urinary albumin excretion was in microalbuminuric stage and had a close to normal estimated glomerular filtration rate. ΔuACR disclosed a positive correlation to baseline serum ICAM 1 (p=0.003, r= 0.31) and serum creatinine (p=0.026, r=0.23). In multiple regression, ICAM-1 (p=0.002) was the main determinant of ΔuACR. The correlation was even stronger in albuminuric patients (p=0.0003, r=0.57). In our type 2 diabetic patients, the main predictor of increase in uACR over one year of follow-up is baseline ICAM -1 level, with a particular role in albuminuric patients. It seems that ICAM-1 might be useful non-invasive biomarker in predicting the progression of DKD.