SynthesisAnnals of internal medicine2026
Proteinuria or Albuminuria as Markers of Kidney and Cardiovascular Disease Risk : An Individual Patient-Level Meta-analysis.
Synthesis in Annals of internal medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 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
11 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- ASN Kidney Health Guidance on the Cardiovascular-Kidney-Metabolic Syndrome.Journal of the American Society of Nephrology : JASN · 2026Guideline
- Placebo-Referenced Class-Level Treatment Effects on Chronic Kidney Disease Progression in Patients With Diabetes: A Network Meta-Analysis.Endocrinology, diabetes & metabolism · 2026Pooled it
- Lack of Short-Term Antiproteinuric Response to Dapagliflozin in a Patient With Dent Disease Type 2.Kidney international reports · 2026Article
- 5-hydroxy-1-methylhydantoin (NZ-419), an endogenous antioxidant, attenuates mycotoxin-induced oxidative stress in human kidney proximal tubular epithelial cells.Clinical and experimental nephrology · 2026Article
- 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
- Reconsidering the measurement of urinary proteins in chronic kidney disease: towards a global consensus on albuminuria assessment.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2026Article
- Association of UACR and UPCR with kidney failure: analysis of observational data in children with chronic kidney disease.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2026Observational
- Urinary Extracellular Vesicles Biomarkers in CKD: Clinical Laboratory Translation.Diagnostics (Basel, Switzerland) · 2026Review
- Albuminuria Levels and Geriatric Outcomes in Predialysis: Chronic Kidney Disease: Falls, Fear of Falling, and Frailty in a Cross-Sectional Study.Journal of clinical medicine · 2026Article
- Intrarenal Hemodynamic Mechanisms of Kidney Protection by Nonsteroidal Mineralocorticoid Receptor Antagonists.Endocrinology and metabolism (Seoul, Korea) · 2026Review
- Albuminuria or proteinuria in glomerular disease and CKD-which one to use?Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2026Article
Corrections and comments
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Authors and funding
28 authors.
Funding
Abstract
backgroundUrinary albumin-creatinine ratio (UACR) and urinary protein-creatinine ratio (UPCR) are both used in clinical practice to diagnose and monitor chronic kidney disease (CKD). Which measure exhibits stronger associations with clinical outcomes and whether this varies by patient characteristics are unknown.
objectiveTo assess and compare the performance of UACR and UPCR across CKD-related clinical outcomes.
designIndividual patient-level meta-analysis.
setting38 research and clinical cohorts.
participants148 994 participants with same-day measurements of UACR and UPCR. MEASUREMENTS: We quantified the associations of UACR and UPCR with subsequent clinical outcomes, including kidney failure and cardiovascular events, using Cox proportional hazards regression. Analyses were done in each cohort, followed by random-effects meta-analysis. Subgroups included those based on severity of proteinuria, type 2 diabetes, estimated glomerular filtration rate (eGFR) less than 60 mL/min/1.73 m
resultsThere were 148 994 participants and 9773 kidney failure events during a median of 3.8 years of follow-up. Higher UACR and UPCR both had a log-linear association with increased risk for kidney failure. The association with kidney failure was somewhat stronger for UACR (adjusted hazard ratio [HR] per SD increment, 2.55 [95% CI, 2.36 to 2.74]) than UPCR (HR, 2.40 [CI, 2.28 to 2.53]; LIMITATION: Assessment of UACR and UPCR in spot urine samples.
conclusionOverall, UACR was more strongly associated with kidney failure than UPCR (particularly in subgroups with higher UACR), supporting the use of UACR rather than UPCR to diagnose and risk-stratify patients. PRIMARY FUNDING SOURCE: National Kidney Foundation and National Institute of Diabetes and Digestive and Kidney Diseases.
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