The most sensitive study to detect diabetic nephropathy in the emergency department is:
Serum creatinine level.
+Serum BUN.
+Urine albumin.
+Protein tolerance test.
+Renal ultrasound.
Diabetic nephropathy can be clinically silent for 10–15 years after the development of disease. Clinically detectable nephropathy begins with the development of microalbuminuria, even though the glomerular filtration rate may be elevated at this time. Only when the protein level reaches 0.5 g/L will it be detectable on a urine dipstick test. Once proteinuria is detected by urine dipstick, there is a decline in renal function at an average of 1 mL/mo. Azotemia begins an average of 12 years after the diagnosis of diabetes.