A 41-year-old woman comes to the office as a new patient. She recently moved to the area. She feels well. She has dyslipidemia treated with pravastatin. Her past three Pap smears have shown no abnormalities; the most recent Pap smear was 2 years ago. The patient has had prediabetes for the last 2 years. She is 155 cm (5 ft 1 in) tall and weighs 70 kg (154 lb); BMI is 29 kg/m2. Her pulse is 68/min and blood pressure is 129/78 mm Hg. Physical examination shows no abnormalities. Laboratory results show a fasting blood glucose of 157 mg/dL and serum creatinine of 0.7 mg/dL. Hemoglobin A1c is 7.4%. Urine assay shows no detectable albuminuria. Which of the following renal changes is most likely present in this patient at this time?

Question

A 41-year-old woman comes to the office as a new patient. She recently moved to the area. She feels well. She has dyslipidemia treated with pravastatin. Her past three Pap smears have shown no abnormalities; the most recent Pap smear was 2 years ago. The patient has had prediabetes for the last 2 years.  She is 155 cm (5 ft 1 in) tall and weighs 70 kg (154 lb); BMI is 29 kg/m2. Her pulse is 68/min and blood pressure is 129/78 mm Hg. Physical examination shows no abnormalities. Laboratory results show a fasting blood glucose of 157 mg/dL and serum creatinine of 0.7 mg/dL.  Hemoglobin A1c is 7.4%.  Urine assay shows no detectable albuminuria.  Which of the following renal changes is most likely present in this patient at this time?

Quizplus · Accepted Answer

Eductional Objective: In diabetic nephropathy, early adaptive changes in the kidney cause a transient increase in glomerular filtration (hyperfiltration).  As diabetic nephropathy progresses, glomerular filtration falls, with a concurrent increase in urine albumin loss.

A 41-Year-Old Woman Comes to the Office as a New