Researchers studied 701 patients with type-2 diabetes and nephropathy.
They compared four tests for predicting renal events. Two involved 24-hour urine collection: urinary protein excretion and urinary albumin excretion. The other two used samples from patients' first morning void: primary albumin concentration and ACR.
ACR measurements that were one standard deviation from the mean were able to predict more than 33 per cent more renal outcomes than the other tests.
'The albumin to creatinine ratio derived from a first morning void displayed the strongest association with the risk for renal events,' the researchers said. 'The predictive value of the first morning void ACR was significantly higher than 24-hour urinary albumin excretion or protein excretion and confirmed the superiority of the first morning void ACR in predicting renal events.'