How is diabetic nephropathy monitored in clinical practice?

• A. Urine albumin-to-creatinine ratio and estimated GFR
• B. Serum potassium level
• C. Urine sodium
• D. 24-hour urine protein

Answer: (C)

Monitoring diabetic nephropathy centers on detecting kidney damage from diabetes and tracking kidney function over time. The standard uses a spot urine albumin-to-creatinine ratio together with the estimated glomerular filtration rate. The albumin-to-creatinine ratio reveals albuminuria, an early sign of glomerular injury, and a spot test is convenient and reproducible when repeated to confirm persistence. The estimated GFR shows how well the kidneys are filtering and helps stage CKD and guide treatment decisions. Using both measures gives a clear picture of progression and response to therapy. While potassium levels, urine sodium, or 24-hour urine protein can be relevant in broader kidney care, they aren’t the routine, primary tools for monitoring diabetic nephropathy in day-to-day practice; potassium can reflect later-stage changes, urine sodium is influenced by diet and other factors, and 24-hour urine collection is less practical and more error-prone than the spot albumin-to-creatinine ratio.