Association of normal range of urinary albumin‐to‐creatinine ratio with all‐cause mortality among diabetic adults with preserved kidney function: National Health and Nutrition Examination Survey ( NHANES ) 2003–2018
Authors' conclusion
In DM adults without overt kidney dysfunction, elevated normal-range UACR was independently related to escalated ACM, particularly in those with normal BMI. To conclude, we underscore the significance of early risk assessment in DM patients with normal-range albuminuria, even without overt kidney dysfunction.
Study context
- Population
- Adults with diabetes mellitus (DM) and preserved eGFR with normal-range urinary albumin-to-creatinine ratio (UACR), NHANES 2003–2018
- Exposure
- Normal-range UACR tertiles and per 10 mg/g increase
- Outcome
- All-cause mortality
Methodological detailsNHANES survey data linked with mortality, nationally representative, multivariable Cox regression, restricted cubic spline, subgroup analyses, ROC analysis
- NHANES survey data linked with mortality
- Nationally representative
- Multivariable Cox regression
- Restricted cubic spline
- Subgroup analyses
- ROC analysis
Main finding
As reported in the abstract
Hazard ratio (95% CI)
High UACR tertilevs Low UACR tertile
1.50(1.18–1.91)
Per 10 mg/g raise in continuous UACR
1.22(1.06–1.40)
- No significant nonlinear relationship between normal-range UACR and all-cause mortality (ACM) (RCS)
- P = 0.080 for nonlinearity
- Significantly lower survival rates in the medium and high UACR groups (Kaplan-Meier)
- P < 0.001
Observational data: associations, not effects.
Further findings
Subgroup analysis: UACR–BMI interaction
- Significant UACR–BMI interaction
- P = 0.033 for interaction
Original publication
Association of normal range of urinary albumin‐to‐creatinine ratio with all‐cause mortality among diabetic adults with preserved kidney function: National Health and Nutrition Examination Survey ( NHANES ) 2003–2018. Diabetes Obes Metab. Published 25 February 2025. doi:10.
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