This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Diabites & Inappropriate Antidiuretic Hormone, Subject name: Medicine
[{'content': 'A patient has IDDM diagnosed at age of 15 years. The most reliable indicator for diabetic nephropathy is: \nSelect and explain. \nA. Urine albumin <50 mg per day in 3 consecutive samples, B. Urinary protein >550 mg per day for 3 consecutive samples, C. Development of diabetic retinopathy, D. Hematuria', 'role': 'user'}, {'content': "Answer: B \nExplanation: Ans. is 'b' i.e Urinary protein > 550mg/day for 3 consecutive sample Presence of urinary protein>300 mg /day indicates progression to overt proteinuria.Once overt proteinuria is present there is steady state decline in G.F.R and -50% of individuals reach end stage renal disease in 7-10 days.Once nephropathy becomes overt the pathological changes are irreversibleStages of diabetic nephropathy : (IDDM)YearStageFindings0IRaised GFR, increase in Renal size and plasma flow2IIThickening in glomerular capillary basement membrane6-10IIIMicroalbuminuria/Albumin excretion rate 30-300mg/day, Appearance of micro albuminuria important predictor of development of overt proteinuria10-15IVClinical nephropathy, gross proteinuria, Albumin>300mg/day. Now the changes are irreversible16-25VEnd stage renal disease", 'role': 'assistant'}]