The albumin:creatinine ratio in the first urine excreted in the morning is better than 24-hour urinary albumin excretion in determining the risk for renal events in patients with type 2 diabetes and nephropathy, data show.

In a study of 701 such patients, 202 (28.8%) experienced renal events (a doubling of serum creatinine or development of end-stage renal disease). The albumin:creatinine ratio calculated from the first-morning void had the strongest association with the risk for these events compared with measures of urinary protein and albumin excretion from a 24-hour urine collection and urinary albumin concentration from a first-morning urine sample.

In conjunction with previous findings, the results suggest that the albumin:creatinine ratio is a feasible and potentially more practical alternative to 24-hour urinary albumin excretion in various populations, researchers concluded in the Journal of the American Society of Nephrology (2010;21:1355-1360).

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