Other renal disorders should be considered if there are any of the following: Heavy proteinuria with only a brief history of diabetes Absence of diabetic retinopathy Rapid onset of heavy proteinuria Gross hematuria RBC casts Rapid decline in glomerular filtration rate (GFR) Small kidney size Urinary protein Patients are tested for proteinuria by routine urinalysis; if proteinuria is present, testing for microalbuminuria is unnecessary because the patient already has macroalbuminuria suggestive of diabetic renal disease.