Bedside diagnostic test to detect underlying diabetic nephropathy
What is a bedside diagnostic test that will suggest the presence of underlying diabetic nephropathy?
Funduscopy. It is believed that the similarities in the vascularization between the retina and the kidneys account for the correlation of the typical microvascular complications commonly seen in patients with diabetes mellitus.
Patients with type 2 diabetes with proliferative retinopathy often present with kidney involvement, manifested by either microalbuminuria (in the earlier stages) or overt proteinuria. Therefore it is recommended that all patients with diabetes and proliferative retinopathy undergo an evaluation of kidney function including testing for microalbuminuria.
It must be remembered that although the presence of retinopathy does support a diabetic source of proteinuria, the lack of diabetic retinopathy does not rule out diabetic nephropathy.