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.
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.
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Who cites it
4 citing papers in PubMed.
- The Role of Finerenone in Cardiorenal Protection and Urine Albumin-to-Creatinine Ratio Modulation.Kidney international reports · 2026Review
- Chronic kidney disease screening to reduce cardiovascular risk: a call to action.American journal of preventive cardiology · 2026Article
- Association of 14-day continuous glucose monitoring-derived postprandial hyperglycemic area with 6-month change in urinary albumin-to-creatinine ratio in patients with newly diagnosed type 2 diabetes mellitus.Frontiers in endocrinology · 2026Article
- Sex differences in the prognostic value of urinary albumin-to-creatinine ratio for coronary artery disease and cardiovascular events in people with type 2 diabetes and normoalbuminuria.Cardiovascular diabetology · 2025Article
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14 authors.
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No grant is acknowledged in the PubMed record.
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.
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