The Impact of uACR on Cardiovascular Disease

Chronic kidney disease (CKD) is a well-established risk factor for cardiovascular (CV) disease because declining kidney function contributes to hypertension, chronic inflammation, vascular calcification, and metabolic disturbances that accelerate atherosclerosis. Even in early CKD, these pathophysiologic changes create a disproportionately high risk of heart failure, myocardial infarction, and CV mortality. Increasing evidence shows that elevated urine albumin-to-creatinine ratio (uACR) is one of the strongest predictors of CV outcomes—often outperforming traditional markers like LDL cholesterol or blood pressure. In clinical practice, this correlation is clear: patients with higher albuminuria frequently experience more rapid CV decline, even when other risk factors appear controlled. As a result, uACR has become an essential tool for identifying high-risk individuals earlier, guiding more aggressive intervention, and tailoring therapy to help reduce long-term cardiovascular complications.