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Renal anemia with hemoglobin (Hb) of 1g/day in 24h urine collection in diabetes with under five years of progress, (3) deterioration of kidney function with and without diabetic retinopathy, (4) alterations in the urinary sediment (dysmorphic red blood cells) not associated with an infectious process (urinary infection), (5) rapid decrease in eGFR in patients with previous stable kidney function or (6) clinical and/or analytical signs of associated immune disease.42,43 Strength of recommendation: 2D Rationale: Some studies have described the following factors associated with nondiabetic kidney lesions: elevated SBP, adequate HbA1c, short duration of diabetes, and absence of retinopathy.44 Diabetic retinopathy has high sensitivity (87%) and specificity (93%) in predicting more severe histological lesions of diabetic kidney disease

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