SynthesisAnnals of internal medicine2020
Conversion of Urine Protein-Creatinine Ratio or Urine Dipstick Protein to Urine Albumin-Creatinine Ratio for Use in Chronic Kidney Disease Screening and Prognosis : An Individual Participant-Based Meta-analysis.
Synthesis in Annals of internal medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 207 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
207 citing papers in PubMed, 6 syntheses or guidelines pooled it, 307 citations in OpenAlex.
- The Association between Low-Grade Proteinuria and Adverse Kidney Outcomes in IgA Nephropathy: A Systematic Review and Meta-Analysis.Clinical journal of the American Society of Nephrology : CJASN · 2026Pooled it
- Chronic kidney disease and incident cancer risk: an individual participant data meta-analysis.British journal of cancer · 2025Pooled it
- Beneficial effects of cell-derived exosomes on diabetic nephropathy: a systematic review and meta-analysis of preclinical evidence.Acta diabetologica · 2025Pooled it
- Systematic review of the application of the Kidney Failure Risk Equation and Oxford classification in estimating prognosis in IgA Nephropathy.Systematic reviews · 2025Pooled it
- Pooled it
- Development and Validation of Prediction Models of Adverse Kidney Outcomes in the Population With and Without Diabetes.Diabetes care · 2022Pooled it
- Increased risk of kidney failure in patients with genetic kidney disorders.The Journal of clinical investigation · 2024Trial
- APOL1 and chronic kidney disease in pediatrics: a study from the Biorepository and Integrative Genomics Initiative.Pediatric nephrology (Berlin, Germany) · 2026Article
- Randomized Trial of Dietary Nitrate Supplementation in CKD Pregnancy (ORCHARD-BEET).Kidney international reports · 2026Article
- Predicting High-Risk CKD in Japanese People: Model Development and Validation.Kidney international reports · 2026Article
- Impact of renin-angiotensin system inhibitors discontinuation in advanced chronic kidney disease: a target trial emulation.Clinical kidney journal · 2026Article
- Continuous Glucose Monitoring and Long-Term Glycemic and Kidney Outcomes.JAMA network open · 2026Article
- Can urinary albumin-creatinine ratio be used as a surrogate for protein-creatinine ratio in the diagnosis and management of pediatric steroid sensitive nephrotic syndrome?Pediatric nephrology (Berlin, Germany) · 2026Article
- Utility of Risk Scores for Predicting Stroke and Intracranial Bleeding Across Levels of Kidney Function in Two Large Community-Based Cohorts of Older Adults With Atrial Fibrillation.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2026Article
- Association between estimated time with low glomerular filtration rate and access to transplant among youth with advanced chronic kidney disease.Pediatric nephrology (Berlin, Germany) · 2026Article
- Mapping the complexity of care in patients with heart disease living with chronic kidney disease.Clinical kidney journal · 2026Article
- Association of UACR and UPCR with kidney failure: analysis of observational data in patients with rare kidney diseases.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2026Observational
- Association of UACR and UPCR with kidney failure: a pooled analysis of clinical trials.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2026Article
- Incidence, time trends and predictors of acute kidney injury in the region of Stockholm, Sweden.Scientific reports · 2026Article
- A deep learning model for opportunistic screening of chronic kidney disease using chest radiographs: a multicentre validation study in the USA.EClinicalMedicine · 2026Article
147 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
Authors and funding
36 authors at 20 institutions in 8 countries.
Funding
Abstract
backgroundAlthough measuring albuminuria is the preferred method for defining and staging chronic kidney disease (CKD), total urine protein or dipstick protein is often measured instead.
objectiveTo develop equations for converting urine protein-creatinine ratio (PCR) and dipstick protein to urine albumin-creatinine ratio (ACR) and to test their diagnostic accuracy in CKD screening and staging.
designIndividual participant-based meta-analysis.
setting12 research and 21 clinical cohorts.
participants919 383 adults with same-day measures of ACR and PCR or dipstick protein. MEASUREMENTS: Equations to convert urine PCR and dipstick protein to ACR were developed and tested for purposes of CKD screening (ACR ≥30 mg/g) and staging (stage A2: ACR of 30 to 299 mg/g; stage A3: ACR ≥300 mg/g).
resultsMedian ACR was 14 mg/g (25th to 75th percentile of cohorts, 5 to 25 mg/g). The association between PCR and ACR was inconsistent for PCR values less than 50 mg/g. For higher PCR values, the PCR conversion equations demonstrated moderate sensitivity (91%, 75%, and 87%) and specificity (87%, 89%, and 98%) for screening (ACR >30 mg/g) and classification into stages A2 and A3, respectively. Urine dipstick categories of trace or greater, trace to +, and ++ for screening for ACR values greater than 30 mg/g and classification into stages A2 and A3, respectively, had moderate sensitivity (62%, 36%, and 78%) and high specificity (88%, 88%, and 98%). For individual risk prediction, the estimated 2-year 4-variable kidney failure risk equation using predicted ACR from PCR had discrimination similar to that of using observed ACR. LIMITATION: Diverse methods of ACR and PCR quantification were used; measurements were not always performed in the same urine sample.
conclusionUrine ACR is the preferred measure of albuminuria; however, if ACR is not available, predicted ACR from PCR or urine dipstick protein may help in CKD screening, staging, and prognosis. PRIMARY FUNDING SOURCE: National Institute of Diabetes and Digestive and Kidney Diseases and National Kidney Foundation.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.