Which of the following is a sign of early diabetic nephropathy?

Microalbuminuria is an early sign of diabetic nephropathy, which is a complication of diabetes characterized by damage to the kidneys. This condition can be identified through the presence of small amounts of protein (specifically albumin) in the urine, which indicates that the kidney's filtration system is beginning to be compromised.

In the early stages of diabetic nephropathy, the kidneys are still functioning well enough that only microscopic levels of albumin leak into the urine, which is referred to as microalbuminuria. This finding is significant because it can be an early indicator of kidney damage and may prompt healthcare providers to implement management strategies aimed at slowing the progression of kidney disease in diabetic patients, such as blood sugar control and the use of medications like ACE inhibitors.

In contrast, nephrotic syndrome, proteinuria (which is a higher level of protein in the urine), and fluid overload are signs of more advanced kidney impairment or other related conditions that typically occur later in the course of diabetic nephropathy or in other renal pathologies. Detecting microalbuminuria allows for earlier intervention, which is critical in managing diabetic nephropathy effectively.