Comparison between different methods of urine collection for estimation of albumin-creatinine ratio in patients with type-2 diabetes mellitus

In patients with diabetes mellitus, urinary albumincreatinine-ratio (ACR) predicts progressive kidney disease. In order to determine the better urine sample for detecting ACR, we estimated ACR in three modes of urine sample. Two hundred patients of uncontrolled diabetes mellitus with proteinuria irrespective of age and sex were studied for urinary ACR in all the three types of samples over a period of 2 years. The statistical analysis showed that first morning ACR (r = 0.999, p > 0.001) of the subjects was more significantly correlated with their 24 hour urine sample ACR than spot urine (r = 0.995, p < 0.001). We conclude that early morning specimens should be used instead of spot and 24 hour sample.