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uACR Monitoring CKD — ESENeph MCQ

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EasyChronic Kidney DiseaseuACR Monitoring CKDESENeph

A 42-year-old woman with CKD G3b from autoimmune TIN has stable proteinuria of 0.5 g/day on Ramipril. She is told that proteinuria is an independent risk factor for CKD progression. What quantitative proteinuria measure does KDIGO 2024 recommend for CKD monitoring?

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Correct answer: C — Urine albumin-to-creatinine ratio (uACR) from a spot sample – preferably first morning void

KDIGO 2024 recommends spot uACR (preferably first-morning void) as the standard measure for proteinuria/albuminuria assessment in CKD. It is preferred over 24-hour collections (which are cumbersome and often inaccurate) and urine dipstick (which lacks sensitivity, especially for low-level albuminuria). First-morning void reduces variability from postural proteinuria. uACR is used for CKD staging (A1/A2/A3), risk stratification, and monitoring treatment response.

Reference: KDIGO 2024 – CKD Guideline