Are there advantages with U‐Albumin/U‐Creatinine ratios compared with U‐Albumin in monitoring diabetes?

Abstract

Management of hypertension and diabetes mellitus in primary health care requires occasional assessment of kidney function. Monitoring the urinary albumin excretion every 24 h is often used as a diagnostic gold standard but measurement of U‐Albumin concentrations in morning urine either alone or together with U‐Creatinine is a well‐established surrogate measure. We compared the ratio U‐Albumin/U‐Creatinine and U‐Albumin concentrations measured by commonly used POC (Point of care) instruments with those obtained in a central laboratory and estimated the uncertainty of the results after establishing an uncertainty budget. It is concluded that the presentation of ratios or concentrations on an ordinal scale is less satisfactory than reporting U‐Albumin concentration on a ratio scale. Moreover the latter will have the advantage of allowing the physician to adjust the diagnostic sensitivity and specificity to local needs. The present report is a methodological study and does not consider the diagnostic performance of the studied properties per se.

• Albumin/creatinine ratio
• microalbuminuria
• uncertainty in measurements

Acknowledgements

The skilful and painstaking help of Ghodsi Zolfager and Christina Peedu is gratefully acknowledged.