94% of researchers rate our articles as excellent or good
Learn more about the work of our research integrity team to safeguard the quality of each article we publish.
Find out more
ORIGINAL RESEARCH article
Front. Med.
Sec. Nephrology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1502597
Absence of Progression Risk of Chronic Kidney Disease in Patients with Urine Protein-Creatinine Ratio Below 500 mg/g: A Cohort Study with Competing Risk Analysis
Provisionally accepted- 1 Department of Nephrology, Fifth Hospital of Shanxi Medical University, Shanxi Provincial People's Hospital,, Taiyuan,Shanxi, China
- 2 The Second Clinical Medical College, Shanxi Medical University, Taiyuan, Shanxi, China, Taiyuan, Shanxi Province, China
- 3 School of Public Health, Shanxi Medical University, Taiyuan, Shanxi Province, China
- 4 Fifth Clinical Medical College, Shanxi Medical University, Taiyuan,, Shanxi Province, China
- 5 Department of Nephrology, Shanxi Provincial Integrated Traditional Chinese Medicine and Western Medicine Hospital, Taiyuan,Shanxi, China
Background: Recent studies demonstrated a connection between minimal albuminuria and the progression of kidney disease, offering insights on the ideal threshold for antiproteinuric treatment.However, Limited data exist regarding the association between Urine Protein-Creatinine Ratio (UPCR) < 500 mg/g and Chronic Kidney Disease (CKD) progression, particularly in the context of competitive risk analysis. We aimed to investigate the correlation between UPCR and the progression of CKD in patients with UPCR below 500mg/g.Initially, 512 patients diagnosed with stages G2-G5 of CKD and UPCR levels below 1000 mg/g were recruited from the CKD-ROUTE cohort. Subsequently, patients with UPCR levels below 500 mg/g underwent further analysis. The Cox proportional hazards model and the competing risk model was utilized.Results: Over a median follow-up of 3.0 years, 24 out of 512 participants experienced progression of CKD. The current study revealed that compared to UPCR levels of 0-300 mg/g, patients with UPCR levels between 700-1000 mg/g had a HR of 4.6 (95% CI 1.8%-12.0%, P = 0.002), while those with UPCR levels between 300-700 mg/g had a HR of 2.3 (95% CI 0.9%-6.2%, P = 0.097). Patients in the 300-500 mg/g range did not show a higher risk compared to the 0-300 mg/g category [HR = 2.5, (95% CI 0.8-8.3), P = 0.120]. The results of the Fine and Gray competing risk survival regression model showed the same trend.In patients with CKD and UPCR levels below 500 mg/g, there was no increased risk of CKD progression associated with the higher proteinuria levels.
Keywords: Proteinuria, Chronic Kidney Disease, progression, Urine protein-to-creatinine ratio, Competing risk analysis
Received: 27 Sep 2024; Accepted: 03 Mar 2025.
Copyright: © 2025 Bai, Zhang, Di, Wang, Wu and Zhou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Yun Zhou, Fifth Clinical Medical College, Shanxi Medical University, Taiyuan,, 030001, Shanxi Province, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.