Table 1—

Diabetic nephropathy stages: cutoff values of urine albumin for diagnosis and main clinical characteristics

StagesAlbuminuria cutoff values (ref. 14)Clinical characteristics (ref. no.)
Microalbuminuria20–199 μg/minAbnormal nocturnal decrease of blood pressure and increased blood pressure levels (163)
30–299 mg/24 hIncreased triglycerides, total and LDL cholesterol, and saturated fatty acids (164, 165)
30–299 mg/g*Increased frequency of metabolic syndrome components (166)
Endothelial dysfunction (167)
Association with diabetic retinopathy, amputation, and cardiovascular disease (168)
Increased cardiovascular mortality (2, 169)
Stable GFR (82)
Macroalbuminuria≥200 μg/minHypertension (99)
≥300 mg/24 hIncreased triglycerides and total and LDL cholesterol (170)
>300 mg/g*Asymptomatic myocardial ischemia (171, 172)
Progressive GFR decline (83, 84)
  • *

    * Spot urine sample.

  • Measurement of total proteinuria (≥500 mg/24 h or ≥430 mg/l in a spot urine sample) can also be used to define this stage.