Association of UACR and UPCR with kidney failure: a pooled analysis of clinical trials
Abstract
Urinary albumin-to-creatinine ratio (UACR) and urinary protein-to-creatinine ratio (UPCR) are widely used markers for chronic kidney disease (CKD) risk stratification. While albuminuria is considered a sensitive predictor of kidney outcomes, proteinuria remains in use due to cost considerations or traditions. To assess their relative utility in prediction, we compared associations of UACR and UPCR with kidney failure in CKD clinical trials. We conducted a pooled analysis of individual participant-level data from four landmark CKD trials: DAPA-CKD, EMPA-KIDNEY, RENAAL, and IDNT. Overall, these trials included 6219 participants with CKD, with and without diabetes, with available UACR and UPCR measurements derived from spot or 24-h urine samples. Associations with kidney failure-defined as dialysis, transplantation, or sustained estimated glomerular filtration rate (eGFR) decline
Fields of Study & Subjects
Chronic Kidney Disease and Diabetes
Cardiovascular Function and Risk Factors
Cardiovascular Disease and Adiposity
Publication details
- Journal / source
- Nephrology Dialysis Transplantation
- Publisher
- Oxford University Press (OUP)
- Volume
- 41
- Issue
- Supplement_2
- Pages
- ii23–ii29
- Publication date
- 23 April 2026
- Language
- EN