Urine albumin ratio showed a stronger link to kidney failure
Both urine ratios were linked to later kidney failure; the albumin ratio's association was somewhat stronger. Cardiovascular findings were generally similar.
Based on the published abstract. The full paper may contain additional methods, results and limitations.
The 30-second takeaway
Higher values of both urine ratios were associated with later kidney failure. The albumin ratio showed a somewhat stronger association, particularly in subgroups with higher albumin ratios. This comparison concerns how markers relate to future outcomes; it does not show that choosing the albumin test improves patients' health.
The authors identify reliance on spot urine samples as a measurement limitation. This abstract-based summary cannot establish causation from the cohort associations.
What researchers found
Adjusted kidney-failure hazard ratios
Each number is a multiplier of the kidney-failure rate at a given time for a standard-deviation increase in that marker, a step based on its variability. These are separate associations, not absolute probabilities or test-choice effects. Median follow-up: 3.8 years.
What researchers compared
Researchers analyzed each cohort separately, then pooled the results. They asked which urine ratio was more strongly associated with later kidney failure and cardiovascular events.
Cardiovascular findings differed
Cardiovascular associations were generally similar across the urine ratios. The albumin ratio showed stronger associations in subgroups with moderately or severely elevated albumin ratios, so the comparison depended on the outcome and subgroup.
The original publication
Proteinuria or Albuminuria as Markers of Kidney and Cardiovascular Disease Risk : An Individual Patient-Level Meta-analysis.
Heerspink HJL, Grams ME, Sang Y et al.
Ann Intern Med · 2026
- PubMed ID
- 41183334
- Record checked
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