Biomarkers · Urine Biomarkers
Urine Albumin-to-Creatinine Ratio (uACR)
Lower values carry lower risk. In NHANES 1999–2018 with linked mortality to 2019, each standard deviation is associated with a hazard ratio of 1.40. Reproduces in NHANES
NHANES, our fit with 95% CIPublished curve
Hazard ratios relative to each curve's own reference value, so the two curves need not cross 1 at the same point. The dotted vertical line marks the NHANES median.
NHANES hazard per SD1.4095% CI 1.37–1.42 · 50,369 adults, 7,218 deaths
Published hazard ratio1.57per SD (95% CI 1.44–1.72) · CKD Prognosis Consortium (1.05 Million Adults Across 21 Cohorts)
Where people sit
Population percentiles (mg/g) by sex and age band. Cycle or source as recorded in the catalogue.
| Sex | Age | 5th | 25th | Median | 75th | 95th | n | Cycle / source |
|---|---|---|---|---|---|---|---|---|
| All | 20-39 | 2.00 | 4.10 | 6.70 | 12.2 | 48.0 | 2,580 | 2017-2018 |
| All | 40-59 | 2.20 | 4.80 | 8.10 | 16.2 | 85.0 | 2,550 | 2017-2018 |
| All | 60+ | 2.60 | 6.10 | 11.8 | 26.4 | 182 | 2,670 | 2017-2018 |
| All | all | 2.20 | 4.80 | 8.20 | 16.5 | 92.4 | 7,800 | 2017-2018 |
| Men | all | 1.80 | 3.90 | 6.80 | 13.9 | 84.1 | 3,780 | 2017-2018 |
| Women | all | 2.70 | 5.80 | 9.90 | 19.8 | 104 | 4,020 | 2017-2018 |
What studies found when this marker was changed
Effects on the biomarker reported in the cited studies. They describe what happened in those populations, not a recommendation for anyone. See all catalogued interventions.
| Type | Intervention | Reported effect | Evidence | Source |
|---|---|---|---|---|
| clinical | Diabetic nephropathy with advanced podocytopathy | +300% to +3000% macroalbuminuria (>300-3000 mg/g) | clinical guideline | De Zeeuw D, et al. Kidney Int. 2004;65:2309-2320. |
| clinical | Uncontrolled malignant hypertension with glomerular hyperfiltration | +200% to +1000% elevation | prospective cohort | Yuyun MF, et al. Am J Hypertens. 2004;17:669-676. |
| pharmacologic | ACE inhibitors / Angiotensin Receptor Blockers (ARBs) or SGLT2 inhibitors | Reduces uACR by 30-50% (reversing microalbuminuria) | RCT | Chronic Kidney Disease Prognosis Consortium. Association of estimated glomerular… |
| pharmacologic | SGLT2 inhibitors (Dapagliflozin / Empagliflozin) | -30% to -45% reduction in albuminuria | rct | Heerspink HJL, et al. Lancet Diabetes Endocrinol. 2016;4:393-406. |
| pharmacologic | ACE inhibitors / ARBs titrated to maximally tolerated doses | -35% to -50% reduction in uACR | rct | Brenner BM, et al. N Engl J Med. 2001;345:861-869. |
| pharmacologic | Non-steroidal MRA (Finerenone 10-20 mg) | -31% reduction in albuminuria in diabetic kidney disease | rct | Bakris GL, et al. N Engl J Med. 2020;383:2219-2229. |
Sources
- Hazard curve: Lancet 2010; 375:2073-2081
- Chronic Kidney Disease Prognosis Consortium. Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in general population cohorts: a collaborative meta-analysis. Lancet. 2010;375(9731):2073-2081.
- Empirical curve: our Cox model with age and sex, NHANES 1999–2018 with linked mortality to 2019.
Map Urine Albumin-to-Creatinine Ratio (uACR) against another biomarker.