Which statement about diabetic nephropathy progression is correct?

Which statement about diabetic nephropathy progression is correct?

• A. Gross hematuria is the earliest sign.
• B. Proteinuria is the earliest sign.
• C. Microalbuminuria is the earliest sign.
• D. Anemia is the earliest sign.

Answer: (C)

In diabetic nephropathy the first detectable change is a subtle increase in glomerular permeability, which allows small amounts of albumin to pass into the urine. This microalbuminuria is the earliest sign of kidney involvement, often detected as a modest albumin-to-creatinine ratio or 30–300 mg of albumin per day. It appears before overt proteinuria and before a measurable drop in kidney function. Gross hematuria isn’t typical of early diabetic kidney disease and would suggest a different issue. As damage advances, proteinuria becomes evident and later, with further nephron loss, anemia can develop due to reduced erythropoietin production. So microalbuminuria is the best marker for the initial phase of diabetic nephropathy.

In diabetic nephropathy the first detectable change is a subtle increase in glomerular permeability, which allows small amounts of albumin to pass into the urine. This microalbuminuria is the earliest sign of kidney involvement, often detected as a modest albumin-to-creatinine ratio or 30–300 mg of albumin per day. It appears before overt proteinuria and before a measurable drop in kidney function. Gross hematuria isn’t typical of early diabetic kidney disease and would suggest a different issue. As damage advances, proteinuria becomes evident and later, with further nephron loss, anemia can develop due to reduced erythropoietin production. So microalbuminuria is the best marker for the initial phase of diabetic nephropathy.