Urine albumin creatinine ratio and clinical correlates in a diabetic population

The urine albumin/creatinine ratio was measured in random urine samples in a range of diabetic subjects as a guide to urinary albumin excretion rate in diabetic patients. In 74 control subjects the 95th percentile for the albumin/creatinine ratio was 1.3. In 39 diabetic patients the random urine albumin/creatinine ratio correlated highly with the 24 hour urine albumin excretion (r = 0.9371, p less than 0.001). In 337 insulin treated diabetic subjects 55% of the female and 39% of the male values exceeded 1.3. In 98 noninsulin treated diabetic subjects 67% of female and 62% of male values exceeded 1.3. Selecting albumin/creatinine ratios between 2.5 to 26.8 corresponding to albumin excretion rates between 20 mg and 250 mg/day, 26.1% of the insulin treated group were in this microalbuminuric range, and 8.7% had overt albuminuria. Higher figures were seen in the noninsulin treated group. Within these two large diabetic groups significant associations (p less than 0.005) were seen with glycaemia, blood pressure, body mass index, retinopathy and duration of diabetes. We believe that measurement of albumin/creatinine ratios on random urine samples offers a simple and convenient way of monitoring albumin excretion in large numbers of diabetic patients.