18 Dec Bayer Survey Highlights Simple Urine Test To Help Predict Heart Disease in Type 2 Diabetes

MedicalResearch.com Interview with:

Dr. Holly Kramer

Dr. Holly Kramer MD, MPH
Professor of Public Health Sciences and Medicine
Division of Nephrology and Hypertension
Loyola University Chicago

MedicalResearch.com: What is the background for this survey? How is UACR measured? Would you explain the significance of albumin in the urine and what creatinine represents?

Response: Approximately 36 million people live with type 2 diabetes (T2D) in the U.S. today, with cardiovascular disease (CVD) being the number one cause of death for this patient population. About 1 in 3 adults with T2D has UACR >30 mg/g with prevalence approaching 40% in older patients.

Compared to patients with T2D alone, those with elevated UACR face:

• • 5-times higher risk of hospitalization for heart failure
  • 4-times higher risk of CV mortality
  • 3-times higher risk of myocardial infarction

Interestingly, once thought of as a traditional renal biomarker, urine albumin-to-creatinine ratio (UACR) >30 is also a critical biomarker and urgent signal of cardiovascular (CV) risk.

When checking UACR, we look at two things: the amount of albumin leaking into the urine and the creatinine level. Albumin shouldn’t be getting through the kidneys’ filters at all, so when we see a UACR >30 mg/g, it’s a sign of systemic vascular endothelial dysfunction. So, if albumin is leaking through the blood vessels inside the kidneys, there’s also damage in the vessels across other organs, like the heart.

UACR is such an important early indicator of CV risk in T2D because even small increases follow a clear ‘rule of three’s’. Healthy kidneys secrete 3 mg/g of albumin to creatinine per day, but when it rises to 30 mg/g, a tenfold increase that signals vascular dysfunction and increasing CV risk. At 300 mg/g, another tenfold increase, the damage is more advanced, and CV risk accelerates.

Patients with eGFR >60 BUT UACR >30 mg/g can have up to 3.6 times increased risk of CV mortality.

As a nephrologist, I’ve been vocal about the potential for this common urine test that we regularly perform, a UACR test, in helping detect CV risk, not just kidney damage, in more patients.

MedicalResearch.com: What are the main findings?

Response:  To better understand Health Care Providers’ (HCP)  perceptions and usage of UACR, Bayer partnered with Sermo on an online national survey of 600+ primary care practitioners who regularly treat T2D patients.

This survey highlighted how important it is to increase awareness of UACR as a critical biomarker for CV risk. The survey showed that:

• • Only 5% of HCPs cite assessing CV risk as the main reason for ordering a UACR test.
  • Only 1 in 4 providers surveyed see UACR as the most critical test to trigger an immediate change in treatment plans for T2D patients with kidney disease to account for their CV risk.
  • Clinical guidelines advise to treat patients with a UACR > 30 mg/g, but less than a third (31%) of providers surveyed act on that score to lower CV risk.
  • Half of providers (48%) are not aware that UACR can independently signal early CV risk 10 or more years earlier than the standard blood test (eGFR).
  • 84% of providers agree there is a need for greater awareness of UACR testing to predict early CV risk for T2D patients. 

MedicalResearch.com: Who should order a UACR test?

Response: Any clinician caring for people with type 2 diabetes can and should order this test at least once per year, and more frequently if results show UACR > 30 mg/g. Primary care physicians can easily include a UACR test in their routine visits. 

MedicalResearch.com: What should readers take away from this report?

Response: We often chase after cholesterol and blood pressure, but elevated UACR deserves the same urgency. UACR >30 mg/g is a critical biomarker of CV risk – not just kidney damage – that should be urgently addressed. Just as we wouldn’t ignore high blood pressure because a patient is already on treatment, we shouldn’t overlook UACR >30 mg/g as a cardiovascular risk signal, even if they’re already on an SGLT2i and RAASi.

According to the American Diabetes Association (ADA) Standards of Care in Diabetes, UACR ≥30 mg/g should trigger immediate clinical action to lower cardiovascular risk in people with T2D and CKD.

MedicalResearch.com:  What recommendations do you have for future research as a result of this survey?

Response: I’m hopeful that awareness is growing from the conversations we’ve been having at medical meetings and the new resources that Bayer is sharing, so it would be interesting to conduct a follow-up survey to see if perception and usage of UACR for detecting CV risk has shifted. And to also look at whether more physicians are treating UACR ≥30 mg/g per clinical guidelines.

MedicalResearch.com:  Is there anything else you would like to add? Any disclosures?

Response: The UACR test is a critical biomarker of cardiovascular risk in T2D patients. Remember to make sure you order the ratio and if the score is 30 or above, there is significant risk that should be addressed.

You can learn more about UACR and its role in the CV risk detection on hcplive.com/interactive-tools/revealtheCVrisk.

Dr. Kramer has served as a consultant and speaker for Bayer and was not compensated for this interview.

Citation: Understanding Albuminuria: CKD Associated with Type 2 Diabetes:
https://cardiorenal.medicalaffairs.bayer.com/disease-education/Albuminuria

—–

The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition.Some links may be sponsored. Products are not warranted or endorsed.

Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.

Last Updated on December 18, 2025 by Marie Benz MD FAAD