This is a PAS stain of nodular glomerulosclerosis (Kimmelstiel-Wilson disease) in a patient with long-standing diabetes mellitus. Note also the markedly thickened arteriole at the lower right which is typical for the hyaline arteriolosclerosis that is seen in diabetic kidneys as well.

Question: What urinalysis finding may presage development of diabetic renal disease?

AnswerThe presence of small amounts of albumin (microalbuminuria) of up to 200 mg/24 hr in the urine may precede overt diabetic nephropathy.