What are the most reliable surrogate markers for early diabetic nephropathy progression in primary care settings without access to advanced biomarker panels?

I am an internal medicine physician conducting primary care based research on diabetic nephropathy in Pakistan. In our setting, advanced biomarkers such as KIM-1, NGAL and cystatin C are unavailable. I am seeking expert consensus on which routinely available markers including urine ACR, eGFR trajectory, blood pressure patterns, and HbA1c best predict early CKD progression in T2DM patients in resource limited environment.

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