
For the purpose of predicting clinical outcomes in patients with diabetes and chronic kidney disease, a change in albuminuria is a good candidate to be a surrogate marker for future cardiovascular events and the progression of kidney disease. Spot urine albumin: creatinine ratio is convenient and recognized as a viable alternative to 24‐hour albumin, with some limitations. Although there is sufficient evidence to validate its use in clinical trials as a surrogate endpoint for renal outcomes, this is not yet the case for cardiovascular outcomes. While the change in albuminuria as a primary or secondary endpoint is trial‐specific, its use should be encouraged, nonetheless.
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