Department of Internal Medicine, Divison of Nephrology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Diabetes Obes Metab. 2023 Jun;25(6):1434-1443. doi: 10.1111/dom.15030. Epub 2023 Mar 8.
For the purpose of predicting clinical outcomes in patients with diabetes and chronic kidney disease, change in albuminuria is a good candidate to be a surrogate marker for future cardiovascular events and progression of kidney disease. Spot urine albumin/creatinine ratio is convenient and recognized as a viable alternative to 24-h albumin, with some limitations. Although there is sufficient evidence to validate its use in clinical trials as a surrogate endpoint for renal outcomes, this is not yet the case for cardiovascular outcomes. While change in albuminuria as a primary or secondary endpoint is trial-specific, its use should be encouraged, nonetheless.
为了预测糖尿病和慢性肾脏病患者的临床结局，尿白蛋白变化是未来心血管事件和肾脏疾病进展的替代标志物。尿白蛋白/肌酐比值方便且被认为是 24 小时尿白蛋白的可行替代方法，但存在一些局限性。尽管有充分的证据验证其在临床试验中作为肾脏结局替代终点的使用，但在心血管结局方面并非如此。虽然尿白蛋白变化作为主要或次要终点是试验特异性的，但仍应鼓励使用。
