Annual screening for early diabetic kidney disease in a patient with type 2 diabetes is best performed using which test?
- A Urine albumin-to-creatinine ratio on a spot sample, with abnormal defined as 30 mg/g or more ✓
- B Serum creatinine alone, interpreted against age
- C Timed overnight urine protein quantification by Biuret method
- D Routine urine dipstick testing for protein twice yearly
Correct answer: A. Urine albumin-to-creatinine ratio on a spot sample, with abnormal defined as 30 mg/g or more
Explanation
Current guidelines recommend annual measurement of the urinary albumin-to-creatinine ratio on a random spot urine sample; persistent values of 30 to 300 mg/g indicate moderately increased albuminuria, the earliest clinically detectable stage of diabetic nephropathy. Dipsticks detect albumin only at concentrations well above this range and miss early disease. Serum creatinine estimates filtration but does not detect the albuminuric phase that precedes a fall in eGFR.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.