Observational studyNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association2026
Association of UACR and UPCR with kidney failure: analysis of observational data in patients with rare kidney diseases.
Observational study in Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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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.
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Who cites it
2 citing papers in PubMed.
- 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
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundProteinuria is associated with long-term kidney failure (KF) risk. In trials of CKD and diabetic kidney disease, urine albumin:creatinine ratio (ACR) has been the preferred urinary protein measurement and features in guidelines and risk-prediction models. In studies of rare, glomerular diseases, urine protein: creatinine ratio (PCR) has more often been used, consequently featuring in treatment algorithms for these diseases. While equations estimating ACR from PCR (estACR) have been developed in large CKD cohorts, whether ACR, PCR, non-albumin proteinuria, and estACR differ in their relationships with KF in patients with rare kidney diseases is unknown.
methodsPatients in RaDaR with same-day ACR and PCR measurements were included. Analyses were undertaken for the whole cohort, and by disease subtype and ACR tertile. Calibration plots assessed the performance of converting PCR to ACR. Cox regression models of time to KF or death (adjusting for age, sex, eGFR, disease) were run with four proteinuria measures: ACR, PCR, non-albumin proteinuria and estACR. Model fit was assessed using AIC (Akaike information criterion) and SBC (Schwarz Bayesian information Criterion) values, ROC curves and time-dependent AUC, and concordance compared using Uno's C statistic.
resultsOut of 4156 patients, 717 (17%) experienced a KF or death event. At lower predicted ACR deciles, conversion of PCR to ACR underestimated true ACR. Very similar AIC and SBC statistics were observed for all proteinuria measurements, including estACR. Time-dependent AUC at 5 years were >0.83 for all models and disease sub-groups. No statistically significant differences in model concordance were seen (Chi2 P > .2 for all comparisons). Within each ACR tertile, AIC, SBC, and AUC values were similar across all proteinuria metrics.
conclusionsIn this cohort of patients with rare kidney diseases, across all levels of proteinuria studied, we identified no statistically significant differences in the performance of ACR, PCR, non-albumin proteinuria, or estACR to predict KF risk.
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