Onset is gradual, and patients may be sick for quite some time without knowing it. Patients in stage 2 excrete more than 30 mg of albumin in the urine over a 24-hour period. Glomerular damage has progressed to clinical albuminuria. Glomerular damage continues, with increasing amounts of protein albumin in the urine. Almost all patients have hypertension at stage 4.
Some patients advance through the stages very quickly.
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