Which of the following is the first clinically detectable sign of diabetic nephropathy
High-Yield Explanation
Answer is C (Microalbuminuria): The first clinically detectable sign of diabetic nephropathy is microalbuminuria'. - General Surgery Principles & International Practice 2008/522 The first sign of diabetic renal disease is microalbumin in the urine '- 'Management of Diabetic Mellitus' 6th (Springer)/359 Microalbuminuria and Diabetic Renal Disease Microalbuminuria is the first clinically detectable sign of diabetic nephropathy Microalbuminuria refers to excretion of albumin in the urine in amounts that are abnormal but below the limit of detection of conventional urine dipsticks() Microalbuminuria is defined as excretion of 30-300 mg of albumin/day in a 24 hour collection() or 30- 300,ug/mge creatinine in a spot collection. The presence of albumin in the urine in the range of microalbuminuria is best determined by a urinary Albumin/Creatinine ratio in a spot voided urine (Prefered method for delecting microalbuminuria)Q Microalbuminuria is best detected by Sensitive RadioimmuneassaysQ The recognition of microalbuminuria in patients with diabetes mellitus allows identification of diabetic nephropathy and institution of treatment to reduce the risk of progressive kidney disease at an earlier stage than would be possible with conventional urine dip-sticks There is clear evidence that the detection of early diabetic nephropathy manifested by microalbuminuria is responsive to antihypeensive therapy in paicular the use of ACE Inhibitors or Angiotensin Receptor Blockers.