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The five stages of nephropathy are shown in this slide. It is important to recognize that the transition from normal to microalbuminuria is in fact a two way street and many individuals will go back from microalbuminuria to normal. Going back from overt nephropathy to microalbuminuria is less frequent, although it does occur. Though many patients with overt nephropathy go onto renal failure the rate of progression does not appear now to be as complete as previous studies suggest.