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Factors that should alert clinicians to possible nondiabetic aetiologies include an absence of retinopathy, duration of diabetes less than five years, acute renal injury pattern of renal dysfunction rather than gradual progression, presence of haematuria or other systemic disease and presence of nephrotic syndrome (albuminuria greater than 3 g/day, low serum albumin level, oedema and symptoms such as frothy urine)

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