Hiddo Heerspink and colleagues from the University of Groingen studied 701 patients with type-2 diabetes and nephropathy.
They compared four tests for predicting renal events. Two involved from 24-hour urine collection: urinary protein excretion (UPE); urinary albumin excretion (UAE). Two used samples from patients’ first-morning void: prinary albumin concentration (UAC) and ACR.
ACR measurements were able to predict over 33% more renal outcomes than the other tests.
Writing in the Journal of the American Society of Nephrology, the researchers said: 'The ACR derived from a first-morning void displayed the strongest association with the risk for renal events.'
They added: ‘The predictive value of the first- morning void albumin:creatinine ratio was significantly higher than 24-hour urinary albumin excretion or protein excretion and confirmed the superiority of the first-morning void albumin: creatinine ratio in predicting renal events.