AUTHOR=Bai Jiang , Zhang Lijuan , Di Jingkai , Wang Wenyu , Wu Yawen , Zhou Yun 

TITLE=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

JOURNAL=Frontiers in Medicine

VOLUME=Volume 12 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2025.1502597

DOI=10.3389/fmed.2025.1502597

ISSN=2296-858X

ABSTRACT=BackgroundRecent 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 500 mg/g.MethodsInitially, 512 patients diagnosed with stages G2-G5 of CKD and UPCR levels below 1,000 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.ResultsOver 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 and 1,000 mg/g had a HR of 4.6 (95% CI 1.8–12.0%, p = 0.002), while those with UPCR levels between 300 and 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.ConclusionIn patients with CKD and UPCR levels below 500 mg/g, there was no increased risk of CKD progression associated with the higher proteinuria levels.