Assessment of albumin/creatinine ratio in the diagnosis of chronic kidney disease in adults

Chronic kidney disease is a public health priority, and affects nearly 10% of the adult population in France. It is defined as gradual reduction in renal function, manifesting itself as a permanent reduction in glomerular filtration rate (GFR).# Early detection can delay or eliminate the need for cumbersome and costly renal replacement treatment. In 2002, ANAES set out guidelines for the management of chronic kidney disease. Since then, many sets of international guidelines have been published, and some of the ANAES guidelines have needed to be reviewed or clarified.# In view of this, CNAMTS [National Salaried Workers’ Health Insurance Fund] and the Ministry of Health, with the aim of improving levels of early detection of chronic kidney disease and improving clinical practice, asked HAS to provide an answer to the following question:# *which is the better method of urine collection for assessment of proteinuria: a 24-hour urine collection or measurement of albumin/creatinine (A/C) or protein/creatinine (P/C) ratio using a spot urine sample?