{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T14:00:19Z","timestamp":1779890419471,"version":"3.53.1"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T00:00:00Z","timestamp":1756252800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Department of Nephrology and Mineral Metabolism"},{"name":"Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,27]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Urine albumin-to-creatinine ratio (uACR) is recommended for follow-up in chronic kidney disease due to its association with progressive kidney disease, cardiovascular events and mortality. In lupus nephritis (LN), response criteria and follow-up are based on urine protein-to-creatinine ratio (uPCR). This study aimed to assess the clinical course and prognostic associations of uACR and uPCR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>uACR and uPCR were evaluated at LN flare, and 3, 6 and 12\u00a0months after initial therapy. We followed the estimated glomerular filtration rate (eGFR) for 36\u00a0months. Correlation between uACR and uPCR was evaluated in all samples and at each timepoint. Predicted uACR was estimated from observed uPCR and agreement between predicted and observed uACR evaluated. The 12-month course of uPCR and uACR was assessed by linear mixed models for repeated measurements and compared over response groups. The ability of uACR and uPCR to predict the stability of kidney function (eGFR decline \u22641\u00a0mL\/min\/1.73 m2\/year) was determined by receiver operating characteristic curves.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We included 106 patients, 93 (88%) female, with a median age of 31\u00a0years [interquartile range (IQR) 21\u201348]. Serum creatinine, uPCR and uACR at LN flare were 0.9\u00a0mg\/dL (IQR 0.6\u20131.3), 3.0\u00a0g\/g (IQR 1.9\u20135.3) and 1.9\u00a0g\/g (IQR 1.1\u20133.7), respectively. uPCR and uACR were highly correlated (r2\u00a0=\u00a00.946) in all samples and at each study timepoint. Predicted and observed uACR had an intraclass correlation coefficient of 0.972, and 81% of values of predicted uACR were within 30% of the observed uACR. The best cutoff for predicting a stable kidney function was 0.71\u00a0g\/g and 0.41\u00a0g\/g for uPCR and uACR, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There is a high correlation and agreement between uACR and uPCR during the first 12\u00a0months of therapy in LN. There is no difference in the uACR\/uPCR ratio between response groups. By 12\u00a0months, a uACR \u22640.41\u00a0g\/g and uPCR \u22640.71\u00a0g\/g are associated with stable kidney function.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ndt\/gfaf176","type":"journal-article","created":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T11:42:27Z","timestamp":1756294947000},"page":"511-519","source":"Crossref","is-referenced-by-count":3,"title":["Albuminuria or proteinuria for response assessment and follow-up in lupus nephritis"],"prefix":"10.1093","volume":"41","author":[{"given":"Valeria","family":"Navarro-S\u00e1nchez","sequence":"first","affiliation":[{"name":"Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n Department of Nephrology and Mineral Metabolism, , Mexico City ,","place":["Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emiliano","family":"Rivero-Otamendi","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n Department of Nephrology and Mineral Metabolism, , Mexico City ,","place":["Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana","family":"Hern\u00e1ndez-Andrade","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n Department of Nephrology and Mineral Metabolism, , Mexico City ,","place":["Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Nordmann-Gomes","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n Department of Nephrology and Mineral Metabolism, , Mexico City ,","place":["Mexico"]},{"name":"Columbia University Irving Medical Center , Department of Medicine, Division of Rheumatology, New York, NY ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Fernanda","family":"Zavala-Miranda","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n Department of Nephrology and Mineral Metabolism, , Mexico City ,","place":["Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela E","family":"S\u00e1nchez-Mej\u00eda","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n Department of Nephrology and Mineral Metabolism, , Mexico City ,","place":["Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristino","family":"Cruz-Rivera","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n Department of Nephrology and Mineral Metabolism, , Mexico City ,","place":["Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4062-9412","authenticated-orcid":false,"given":"Juan M","family":"Mejia-Vilet","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n Department of Nephrology and Mineral Metabolism, , Mexico City ,","place":["Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,8,27]]},"reference":[{"key":"2026022705022265200_bib1","doi-asserted-by":"publisher","first-page":"991756","DOI":"10.3389\/fphys.2022.991756","article-title":"New insights into proteinuria\/albuminuria","volume":"13","author":"Comper","year":"2022","journal-title":"Front Physiol"},{"key":"2026022705022265200_bib2","doi-asserted-by":"publisher","first-page":"S16","DOI":"10.1111\/j.1523-1755.2004.09204.x","article-title":"Which albumin should we measure?","volume":"66","author":"Becker","year":"2004","journal-title":"Kidney Int"},{"key":"2026022705022265200_bib3","doi-asserted-by":"publisher","first-page":"270","DOI":"10.1016\/j.jacc.2022.10.028","article-title":"Albuminuria and heart failure","volume":"81","author":"Khan","year":"2023","journal-title":"J Am Coll Cardiol"},{"key":"2026022705022265200_bib4","doi-asserted-by":"publisher","first-page":"467","DOI":"10.7326\/M23-2814","article-title":"Association of albuminuria with chronic kidney disease progression in persons with chronic kidney disease and normoalbuminuria","volume":"177","author":"Verma","year":"2024","journal-title":"Ann Intern Med"},{"key":"2026022705022265200_bib5","doi-asserted-by":"publisher","first-page":"350","DOI":"10.1053\/j.ajkd.2021.02.335","article-title":"Changes in GFR and albuminuria in routine clinical practice and the risk of kidney disease progression","volume":"78","author":"Neuen","year":"2021","journal-title":"Am J Kidney Dis"},{"key":"2026022705022265200_bib6","doi-asserted-by":"publisher","first-page":"955","DOI":"10.1681\/ASN.0000000000000117","article-title":"Change in albuminuria and GFR slope as joint surrogate end points for kidney failure: implications for phase 2 clinical trials in CKD","volume":"34","author":"Heerspink","year":"2023","journal-title":"J Am Soc Nephol"},{"key":"2026022705022265200_bib7","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1016\/j.kint.2023.09.002","article-title":"KDIGO 2024 Clinical Practice Guideline for the management of lupus nephritis","volume":"105","author":"Rovin","year":"2024","journal-title":"Kidney Int"},{"key":"2026022705022265200_bib8","doi-asserted-by":"publisher","first-page":"392","DOI":"10.1053\/j.ajkd.2016.02.042","article-title":"Early Change in urine protein as a surrogate end point in studies of IgA nephropathy: an individual-patient meta-analysis","volume":"68","author":"Inker","year":"2016","journal-title":"Am J Kidney Dis"},{"key":"2026022705022265200_bib9","doi-asserted-by":"publisher","first-page":"469","DOI":"10.2215\/CJN.08600718","article-title":"Proteinuria reduction as a surrogate end point in trials of IgA nephropathy","volume":"14","author":"Thompson","year":"2019","journal-title":"Clin J Am Soc Nephol"},{"key":"2026022705022265200_bib10","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1136\/ard-2023-224762","article-title":"EULAR recommendations for the management of systemic lupus erythematosus: 2023 update","volume":"83","author":"Fanouriakis","year":"2024","journal-title":"Ann Rheum Dis"},{"key":"2026022705022265200_bib11","doi-asserted-by":"publisher","first-page":"46","DOI":"10.2215\/CJN.03280807","article-title":"Value of a complete or partial remission in severe lupus nephritis","volume":"3","author":"Chen","year":"2008","journal-title":"Clin J Am Soc Nephrol"},{"key":"2026022705022265200_bib12","doi-asserted-by":"publisher","first-page":"1136","DOI":"10.1093\/rheumatology\/keac407","article-title":"Characteristics and outcomes of a Hispanic lupus nephritis cohort from Mexico","volume":"62","author":"Zavala-Miranda","year":"2023","journal-title":"Rheumatology (Oxford)"},{"key":"2026022705022265200_bib13","doi-asserted-by":"publisher","first-page":"e000123","DOI":"10.1136\/lupus-2015-000123","article-title":"A proteinuria cut-off level of 0.7\u2005g\/day after 12\u2005months of treatment best predicts long-term renal outcome in lupus nephritis: data from the MAINTAIN Nephritis Trial","volume":"2","author":"Tamirou","year":"2015","journal-title":"Lupus Sci Med"},{"key":"2026022705022265200_bib14","doi-asserted-by":"crossref","first-page":"1305","DOI":"10.1002\/art.39026","article-title":"Predictors of long-term renal outcome in lupus nephritis trials: lessons learned from the Euro-Lupus Nephritis cohort","volume":"67","author":"Dall'Era","year":"2015","journal-title":"Arthritis Rheumatol"},{"key":"2026022705022265200_bib15","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1007\/s10067-018-4256-2","article-title":"Non-albumin proteinuria as a parameter of tubulointerstitial inflammation in lupus nephritis","volume":"38","author":"Kwon","year":"2019","journal-title":"Clin Rheumatol"},{"key":"2026022705022265200_bib16","doi-asserted-by":"publisher","first-page":"813","DOI":"10.1007\/s00467-009-1381-9","article-title":"Proteinuria and events beyond the slit","volume":"25","author":"Nielsen","year":"2010","journal-title":"Pediatr Nephrol"},{"key":"2026022705022265200_bib17","doi-asserted-by":"publisher","first-page":"10165","DOI":"10.1038\/s41598-021-89442-7","article-title":"Distribution of estimated glomerular filtration rate and determinants of its age dependent loss in a German population-based study","volume":"11","author":"Waas","year":"2021","journal-title":"Sci Rep"},{"key":"2026022705022265200_bib18","doi-asserted-by":"publisher","first-page":"426","DOI":"10.7326\/M20-0529","article-title":"Conversion of urine protein-creatinine ratio or urine dipstick protein to urine albumin-creatinine ratio for use in chronic kidney disease screening and prognosis: an individual participant-based meta-analysis","volume":"173","author":"Sumida","year":"2020","journal-title":"Ann Intern Med"},{"key":"2026022705022265200_bib19","doi-asserted-by":"publisher","first-page":"137","DOI":"10.7326\/0003-4819-139-2-200307150-00013","article-title":"National Kidney Foundation Practice Guidelines for Chronic Kidney Disease: evaluation, classification, and stratification","volume":"139","author":"Levey","year":"2003","journal-title":"Ann Intern Med"},{"key":"2026022705022265200_bib20","doi-asserted-by":"publisher","first-page":"840","DOI":"10.1053\/j.ajkd.2009.04.016","article-title":"Nephrotic syndrome in diabetic kidney disease: an evaluation and update of the definition","volume":"54","author":"Stoycheff","year":"2009","journal-title":"Am J Kidney Dis"},{"key":"2026022705022265200_bib21","doi-asserted-by":"publisher","first-page":"1028","DOI":"10.2215\/CJN.04761107","article-title":"Relationship between albuminuria and total proteinuria in systemic lupus erythematosus nephritis","volume":"3","author":"Birmingham","year":"2008","journal-title":"Clin J Am Soc Nephrol"},{"key":"2026022705022265200_bib22","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1159\/000188429","article-title":"Glomerular filtration rate and urinary albumin excretion rate in systemic lupus erythematosus","volume":"69","author":"Cottiero","year":"1995","journal-title":"Nephron"},{"key":"2026022705022265200_bib23","doi-asserted-by":"publisher","first-page":"386","DOI":"10.1136\/ard.56.6.386","article-title":"Urinary albumin excretion in patients with systemic lupus erythematosus without renal disease","volume":"56","author":"Batlle-Gualda","year":"1997","journal-title":"Ann Rheum Dis"},{"key":"2026022705022265200_bib24","doi-asserted-by":"publisher","first-page":"1331","DOI":"10.1038\/ki.2010.550","article-title":"Lower estimated glomerular filtration rate and higher albuminuria are associated with mortality and end-stage renal disease. A collaborative meta-analysis of kidney disease population cohorts","volume":"79","author":"Astor","year":"2011","journal-title":"Kidney Int"},{"key":"2026022705022265200_bib25","doi-asserted-by":"publisher","first-page":"1341","DOI":"10.1038\/ki.2010.536","article-title":"Lower estimated glomerular filtration rate and higher albuminuria are associated with all-cause and cardiovascular mortality. A collaborative meta-analysis of high-risk population cohorts","volume":"79","author":"van der Velde","year":"2011","journal-title":"Kidney Int"},{"key":"2026022705022265200_bib26","doi-asserted-by":"publisher","first-page":"469","DOI":"10.2215\/CJN.08600718","article-title":"Proteinuria reduction as a surrogate end point in trials of IgA nephropathy","volume":"14","author":"Thompson","year":"2019","journal-title":"Clin J Am Soc Nephol"},{"key":"2026022705022265200_bib27","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1093\/ndt\/gfae085","article-title":"Albuminuria predicts kidney events in IgA nephropathy","volume":"40","author":"Faucon","year":"2025","journal-title":"Nephrol Dial Transplant"},{"key":"2026022705022265200_bib28","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1093\/ndt\/gfae151","article-title":"The use of albuminuria or proteinuria for risk prediction in IgAN","volume":"40","author":"Cheung","year":"2024","journal-title":"Nephrol Dial Transplant"},{"key":"2026022705022265200_bib29","doi-asserted-by":"publisher","first-page":"e001331","DOI":"10.1136\/lupus-2024-001331","article-title":"Lupus nephritis randomised controlled trials: evidence gaps and under-represented groups","volume":"11","author":"Nordmann-Gomes","year":"2024","journal-title":"Lupus Sci Med"},{"key":"2026022705022265200_bib30","first-page":"97","article-title":"Laboratory measurement of urine albumin and urine total protein in screening for proteinuria in chronic kidney disease","volume":"32","author":"Martin","year":"2011","journal-title":"Clin Biochem Rev"},{"key":"2026022705022265200_bib31","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1111\/jdi.14293","article-title":"The health-economic impact of urine albumin-to-creatinine testing for chronic kidney disease in Japanese patients with type 2 diabetes","volume":"16","author":"Asahi","year":"2025","journal-title":"J Diabetes Invest"},{"key":"2026022705022265200_bib32","doi-asserted-by":"publisher","first-page":"583","DOI":"10.1007\/s10157-024-02600-9","article-title":"The health-economic impact of urine albumin-to-creatinine ratio testing for chronic kidney disease in Japanese non-diabetic patients","volume":"29","author":"Konta","year":"2025","journal-title":"Clin Exp Nephrol"},{"key":"2026022705022265200_bib33","doi-asserted-by":"publisher","first-page":"e000089","DOI":"10.1136\/lupus-2015-000089","article-title":"Identification of clinical and serological factors during induction treatment of lupus nephritis that are associated with renal outcome","volume":"2","author":"Dall'Era","year":"2015","journal-title":"Lupus Sci Med"},{"key":"2026022705022265200_bib34","doi-asserted-by":"publisher","first-page":"526","DOI":"10.1136\/annrheumdis-2014-206897","article-title":"Long-term follow-up of the MAINTAIN Nephritis Trial, comparing azathioprine and mycophenolate mofetil as maintenance therapy of lupus nephritis","volume":"75","author":"Tamirou","year":"2016","journal-title":"Ann Rheum Dis"},{"key":"2026022705022265200_bib35","doi-asserted-by":"publisher","first-page":"1117","DOI":"10.1056\/NEJMoa2001180","article-title":"Two-year, randomized, controlled trial of belimumab in lupus nephritis","volume":"383","author":"Furie","year":"2020","journal-title":"N Engl J Med"},{"key":"2026022705022265200_bib36","doi-asserted-by":"publisher","first-page":"3532","DOI":"10.1016\/j.ekir.2024.09.028","article-title":"Long-term kidney outcome of lupus nephritis by renal response status","volume":"9","author":"Yap","year":"2024","journal-title":"Kidney Int Rep"},{"key":"2026022705022265200_bib37","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1053\/j.ajkd.2008.04.014","article-title":"A Comparison of urinary albumin-total protein ratio to phase-contrast microscopic examination of urine sediment for differentiating glomerular and nonglomerular bleeding","volume":"52","author":"Ohisa","year":"2008","journal-title":"Am J Kidney Dis"},{"key":"2026022705022265200_bib38","doi-asserted-by":"publisher","first-page":"1534","DOI":"10.1093\/ndt\/gfr708","article-title":"The value of simultaneous measurements of urinary albumin and total protein in proteinuric patients","volume":"27","author":"Smith","year":"2012","journal-title":"Nephrol Dial Transplant"},{"key":"2026022705022265200_bib39","doi-asserted-by":"publisher","first-page":"hcab100.086","DOI":"10.1093\/qjmed\/hcab100.086","article-title":"Non-albumin proteinuria in lupus nephritis with tubulointerstitial inflammation and its clinical significance","volume":"114","author":"Okba","year":"2021","journal-title":"QJM"},{"key":"2026022705022265200_bib40","doi-asserted-by":"publisher","first-page":"e77608","DOI":"10.7759\/cureus.77608","article-title":"Utility of non-albumin proteinuria for the assessment of the severity of tubulointerstitial inflammation in lupus nephritis patients","volume":"17","author":"Jahan","year":"2025","journal-title":"Cureus"}],"container-title":["Nephrology Dialysis Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ndt\/advance-article-pdf\/doi\/10.1093\/ndt\/gfaf176\/64143610\/gfaf176.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ndt\/article-pdf\/41\/3\/511\/64143610\/gfaf176.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ndt\/article-pdf\/41\/3\/511\/64143610\/gfaf176.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T10:02:31Z","timestamp":1772186551000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ndt\/article\/41\/3\/511\/8242173"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,27]]},"references-count":40,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,8,27]]},"published-print":{"date-parts":[[2026,2,27]]}},"URL":"https:\/\/doi.org\/10.1093\/ndt\/gfaf176","relation":{},"ISSN":["0931-0509","1460-2385"],"issn-type":[{"value":"0931-0509","type":"print"},{"value":"1460-2385","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,3]]},"published":{"date-parts":[[2025,8,27]]}}}