What is the significance of microalbuminuria in the natural history of diabetic nephropathy?
When measured under the right conditions (see above) and confirmed by a second measurement, a spot urine microalbumin level of >30 to 300 µg/mg creatinine indicates incipient nephropathy. Levels >300 µg microalbumin/mg creatinine are consistent with gross proteinuria; precise quantitation of proteinuria in a 24-hour urine collection is indicated for proper management of such patients. Sequential phases in the natural history of diabetic nephropathy involve initial glomerular hyperfiltration, followed by microalbuminuria, persistent gross proteinuria (>300 µg/mg creatinine or >300 mg/24 h), nephrotic syndrome, and end-stage renal failure. Histologic lesions consistent with diabetic kidney disease are seen in ~100% of patients with type 1 diabetes with proteinuria and ~85% of patients with type 2 diabetes with proteinuria and concomitant retinopathy. Microalbuminuria, a potentially reversible stage of incipient nephropathy, precedes gross proteinuria by several years in both type 1 and t
When measured under the right conditions (see above) and confirmed by a second measurement, a spot urine microalbumin level of >30 to 300 µg/mg creatinine indicates incipient nephropathy. Levels >300 µg microalbumin/mg creatinine are consistent with gross proteinuria; precise quantitation of proteinuria in a 24-hour urine collection is indicated for proper management of such patients. Sequential phases in the natural history of diabetic nephropathy involve initial glomerular hyperfiltration, followed by microalbuminuria, persistent gross proteinuria (>300 µg/mg creatinine or >300 mg/24 h), nephrotic syndrome, and end-stage renal failure. Histologic lesions consistent with diabetic kidney disease are seen in ~100% of patients with type 1 diabetes with proteinuria and ~85% of patients with type 2 diabetes with proteinuria and concomitant retinopathy. Microalbuminuria, a potentially reversible stage of incipient nephropathy, precedes gross proteinuria by several years in both type 1 and t
