Albuminuria

UACR testing adds prognostic value by capturing cardiovascular risk and kidney damage that eGFR alone can miss. Urinary albumin quantification predicts long-term prognosis in chronic kidney disease. Higher UACR at baseline was associated with a more adverse clinical profile including older age, higher BMI, lower eGFR, and higher rates of hypertension and diabetes. Incident albuminuria risks were comparable for lobeglitazone plus metformin versus sulfonylurea plus metformin and DPP4 inhibitor plus metformin. Lobeglitazone plus metformin had a lower but non-significant incident albuminuria risk compared with metformin monotherapy. Adding UACR to eGFR screening produced more QALY gains than eGFR-only screening. Incident albuminuria results followed the same general pattern as the primary renal outcome. Incident albuminuria was assessed in a separate analysis among patients with baseline urinary albumin-to-creatinine ratio below 30 mg/g creatinine. Prior evidence linking elevated UACR to cardiovascular events and mortality has been concentrated in populations with diabetes, hypertension, or prior cardiovascular disease, with limited and inconsistent data from East Asian community popu…