Progression of nephropathy in type 2 diabetes. Following 10 years of stable renal function and normal UAE rate (<20 μg/min or <30 mg/d), UAE increases in 20–40% of type 2 diabetic patients. UAE persistently in the range of 20–200 μg/min or 30–300 mg/d (microalbuminuria) heralds the onset of incipient nephropathy. If left untreated, 20–40% of patients progress to overt nephropathy, a syndrome of macroalbuminuria (UAE rate >200 μg/min or >300 mg/d), declining glomerular filtration rate, and increased cardiovascular morbidity. With the onset of macroalbuminuria renal function progressively declines, and ESRDs eventually develop, requiring RRT with dialysis or transplantation. Diabetics with overt proteinuria have a higher risk of dying from cardiovascular disease (122).