Evidence map›Paper›PMID 41093599›Full record

ArticleBMJ open diabetes research & care2025

Change in urine albumin-to-creatinine ratio and clinical outcomes in patients with chronic kidney disease and type 2 diabetes.

Navdeep Tangri, Rakesh Singh, Yan Chen, Keith A Betts, Youssef Mk Farag, Scott Beeman, Yuxian Du, Sheldon X Kong, Todd Williamson, Qixin Li and 4 more

Abstract read
In one paragraph

Article in BMJ open diabetes research & care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Navdeep TangriDepartment of Community Health Services, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada ntangri@sogh.mb.ca.ORCID http://orcid.org/0000-0002-5075-6370
Rakesh SinghBayer U.S. LLC, Whippany, New Jersey, USA.
Yan ChenAnalysis Group Inc, Los Angeles, California, USA.ORCID http://orcid.org/0000-0002-5317-1909
Keith A BettsAnalysis Group Inc, Los Angeles, California, USA.ORCID http://orcid.org/0000-0002-3088-7453
Youssef Mk FaragBayer U.S. LLC, Whippany, New Jersey, USA.
Scott BeemanBayer U.S. LLC, Whippany, New Jersey, USA.
Yuxian DuBayer U.S. LLC, Whippany, New Jersey, USA.
Sheldon X KongBayer U.S. LLC, Whippany, New Jersey, USA.
Todd WilliamsonBayer U.S. LLC, Whippany, New Jersey, USA.
Qixin LiBayer U.S. LLC, Whippany, New Jersey, USA.
Aozhou WuAnalysis Group Inc, Los Angeles, California, USA.
Manasvi SundarAnalysis Group Inc, Los Angeles, California, USA.
Brendan RabideauAnalysis Group Inc, Los Angeles, California, USA.
Kevin M PantaloneDepartment of Endocrinology and Metabolism, Cleveland Clinic, Cleveland, Ohio, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThis study aims to investigate the association between change in urine albumin-to-creatinine ratio (UACR) and clinical outcomes in patients with chronic kidney disease (CKD) and type 2 diabetes. RESEARCH DESIGN AND

methodsAdult patients with elevated UACR (≥30 mg/g in initial testing) after the diagnosis of type 2 diabetes and CKD were identified from the Optum electronic health records database (01/2007-09/2021). UACR change from initial to last test (6-24 months) was categorized as >30% decrease, stable (-30% to 30%), or >30% increase. Risk of all-cause mortality, composite cardiovascular (CV) outcome (CV death, myocardial infarction, stroke, and hospitalization for heart failure), and CKD progression (≥40% decline in estimated glomerular filtration rate or kidney failure) were estimated with Cox proportional hazard models adjusted for baseline characteristics.

resultsCompared with patients with a stable UACR (n=35 117), those with a >30% UACR decrease (n=89 562) had lower risk of all-cause mortality (adjusted HR (aHR)=0.93, 95% CI 0.90 to 0.96), composite CV outcomes (aHR=0.93, 95% CI 0.90 to 0.95), and CKD progression (aHR=0.84, 95% CI 0.81 to 0.86) (all p<0.001), and patients with a >30% UACR increase (n=35 703) had higher risk of each endpoint (aHR=1.24, 95% CI 1.19 to 1.28; aHR=1.24, 95% CI 1.20 to 1.28; and aHR=1.41, 95% CI 1.36 to 1.46, respectively; all p<0.001).

conclusionsIn patients with CKD and type 2 diabetes, a >30% UACR decrease was associated with lower risk of mortality, CV events, and CKD progression, whereas a >30% UACR increase was associated with higher risk of these clinical outcomes. These findings highlight the importance of albuminuria monitoring and potential clinical benefits of targeted UACR reductions in this population.

Indexed as

AlbuminuriaBiomarkersCreatinineDiabetes Mellitus, Type 2Renal Insufficiency, ChronicAgedCardiovascular DiseasesDisease ProgressionFemaleFollow-Up StudiesGlomerular Filtration RateHumansMaleMiddle AgedPrognosisRisk FactorsBiomarkersCreatinineAlbuminuriaDiabetes Mellitus, Type 2Kidney Diseases

Identifiers

PMID41093599
PMCPMC12551518

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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.