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Abstract
Proteinuria is abnormal increase in protein excertion, it is a sign of kidney disease. Patients with diabetes mellitus are at high risk of suffering renal damage.
Diabetic nephropathy has five stages:
Stage I or hypertrophy hyperperfusion stage at the clinical diagnosis, stage II or stage of development of structural lesions but with normal or near normal urinary albumin excertion, stage III or incipient diabetic nephropathy characterized by persisting and increasing microalbuminuria (20-200 µg/min)over several years, stage IV or overt diabetic nephropathy characterized by clinical proteinuria (UAE > 200 µg/min) detected by conventional method as albustix method and lasty stage V, end stage renal failure characterised by uraemia.
Once diabetic nephropathy occurs renal function deteriorates rapidly and renal insufficiency evolves, treatment at this stage can slowdown progression but not stop it or reverse it. It was reported that persistant proteinuria detectable by routine screening tests (equivalent to urinary albumin excretion (UAE) rate ?200 ug/min e.g. (Albustix) suggests diabetic nephropathy. Preceding this stage is a period of increased UAE not detected by routine methods, this range of 20-200 µg/min (or 30-300 mg/24h) of increased UAE defines microalbuminuria.