Moderately increased albuminuria is a biomarker for early onset diabetic nephropathy. The aim of this study was to evaluate the performance of use proteinuria-to-creatininuria ratio (UPCR) at different cut-off to screen for increased albuminuria using albuminuria-to-creatininuria ratio (UACR) as a gold standard. This was a cross-sectional study. A random spot urine sample was collected from patients with type 1 diabetes to measure albuminuria and total proteinuria using respectively an immunoturbidimetric and a colorimetric assay. Albuminuria was expressed as UACR and proteinuria as UPCR. The area under the curve (AUC) method and the kappa coefficient were used to compare UPCR and UACR. In 150 diabetic patients, moderately increased albuminuria was detected in 33.3% using UACR and 35.3% using UPCR at 272 mg/g. UPCR thresholds of 130, 150, 180 and 200 mg/g yielded higher detection rates than UACR. However, all UPCR cut-offs showed low diagnostic accuracy (AUC < 70%), and agreement with UACR was mild (kappa < 0.40). The level of agreement between UPCR and UACR was moderate. It is not sufficient for UPCR to replace UACR to screen for increased albuminuria in patient with type 1 diabetes.
Ndour et al. (Wed,) studied this question.