Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • News & Views
  • Published:

Chronic kidney disease

Defining clinical cut-offs for albumin:creatinine ratio

Albuminuria is rapidly gaining recognition as a marker of the presence and of the progression of chronic kidney disease (CKD). In a new study, Naresh et al. attempt to define cut-off values for percentage change in urinary albumin:creatinine ratio that reflect changes in CKD status rather than random biological variation.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1: Log-transformation might be required to enable accurate interpretation of ACR data.

References

  1. Naresh, C. N., Hayen, A., Weening, A., Craig, J. C. & Chadban, S. J. Day-to-day variability in spot urine albumin-creatinine ratio. Am. J. Kidney. Dis. http://dx.doi.org/10.1053/j.ajkd.2013.06.016.

  2. Levey, A. S. et al. The definition, classification, and prognosis of chronic kidney disease: a KDIGO Controversies Conference report. Kidney Int. 80, 17–28 (2011).

    Article  Google Scholar 

  3. Mosca, A. et al. Biological variability of albumin excretion rate and albumin-to-creatinine ratio in hypertensive type 2 diabetic patients. Clin. Chem. Lab. Med. 41, 1229–1233 (2003).

    CAS  PubMed  Google Scholar 

  4. Lambers Heerspink, H. J., Brinkman, J. W., Bakker, S. J. L., Gansevoort, R. T. & de Zeeuw, D. Update on microalbuminuria as a biomarker in renal and cardiovascular disease. Curr. Opinion Nephrol. Hypertens. 15, 631–636 (2006).

    Article  Google Scholar 

  5. Lambers Heerspink, H. J. et al. Albuminuria assessed from first-morning-void urine samples versus 24-h urine collections as a predictor of cardiovascular morbidity and mortality. Am. J. Epidemiol. 168, 897–905 (2008).

    Article  Google Scholar 

  6. National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am. J. Kidney Dis. 39 (Suppl. 1), S1–S266 (2002).

  7. Johnson, D. W. et al. Chronic kidney disease and measurement of albuminuria or proteinuria: a position statement. Med. J. Aust. 197, 224–225 (2012).

    PubMed  Google Scholar 

  8. Bland, J. M. & Altman, D. G. Measuring agreement in method comparison studies. Stat. Methods Med. Res. 8, 135–160 (1999).

    Article  CAS  Google Scholar 

  9. Armbruster, D. A. & Pry, T. Limit of blank, limit of detection and limit of quantitation. Clin. Biochem. Rev. 29 (Suppl. 1), S49–S52 (2008).

    PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Ethics declarations

Competing interests

The author declares no competing financial interests.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bakker, S. Defining clinical cut-offs for albumin:creatinine ratio. Nat Rev Nephrol 9, 710–712 (2013). https://doi.org/10.1038/nrneph.2013.233

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/nrneph.2013.233

Search

Quick links

Nature Briefing: Translational Research

Sign up for the Nature Briefing: Translational Research newsletter — top stories in biotechnology, drug discovery and pharma.

Get what matters in translational research, free to your inbox weekly. Sign up for Nature Briefing: Translational Research