<prompt> The earliest feature of diabetic nephropathy is-MicroalbuminuriaIncreased serum creatinineNephrotic syndromeHematuria  <response>: Ans. is a i.e., Microalbuminuria STAGES O F DIABETIC NEPHROPATHY: IDDMYearStageFindings0Io Raised GFR, increase in Renal size and plasma flow2IIo Thickening in glomerular capillary basement membrane6-10IIIo MicroalbuminuriaAlbumin excretion rate 30-300mgday, Appearance of micro albuminuria important predictor of development of overt proteinuria10-15IVo Clinical nephropathy, gross proteinuria, Albumin300mgday. Now the changes are irreversible16-25Vo End stage renal diseaseo Microalbuminuria is defined as albumin excretion of 30-300 mgdQo Overt nephropathy or overt proteinuria is defined as albumin excretion ereater than 300 mgdQo The appearance of microalbuminuria in type I diabetes mellitus is an important predictor of progression to overt proteinuria 300 mgday or overt nephropathy.REMEMBERo The early pathological changes and albumin excretion abnormalities are reversible with normalization of plasma glucoseQ.o However, once overt nephropathy develops the pathological chanees are likely irreversible. there is steady decline in GFR and 50 of individuals reach ESRD in 7-10 yearsQ. 