Fast Five Quiz: Diabetic Nephropathy

A. Brent Alper, Jr, MD, MPH

Disclosures

April 24, 2020

In the appropriate setting, serum and urinary electrophoresis can be performed to help exclude multiple myeloma and to classify the proteinuria, which is primarily glomerular in diabetic nephropathy.

Blood tests, including calculation of GFR by various formulas, such as the MDRD formula, are useful for monitoring disease progression and assessing disease stage.

Renal biopsy is not routinely indicated in all cases of diabetic nephropathy, particularly when patients have a typical history and characteristic disease progression. However, it may be indicated if the diagnosis is in doubt, if other kidney disease is suggested, or in the presence of atypical features.

A 24-hour urine measurement for urea, creatinine, and protein is extremely useful in quantifying protein losses and estimating the GFR. Common urinalysis results from patients with established diabetic nephropathy show proteinuria varying from 150 mg/dL to > 300 mg/dL, glucosuria, and occasional hyaline casts.

Learn more about the workup for diabetic nephropathy.

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