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Answer 3
  1. Urine albumin measurement. The most sensitive test for detecting diabetic nephropathy is a urine albumin test, which would reveal the presence of microalbuminuria. This finding appears much earlier than any change in creatinine level or any anatomic changes in the kidneys. The creatinine clearance can vary depending on the stage of diabetes mellitus, increasing in the first few years following diagnosis and decreasing progressively some years later. Although diseases other than diabetes mellitus can cause changes in the creatinine level or the anatomy of the kidneys, microalbuminuria is the most characteristic finding of diabetic nephropathy.

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