Construction of a Risk Prediction Model for Diabetic Nephropathy Based on the Urinary Microalbumin-to-Creatinine Ratio and Blood Markers

Abstract

Objective: To investigate the predictive value of blood creatinine (Cr), blood urea (Ur), blood uric acid (Ua), serum homocysteine (Hcy), glycated hemoglobin (HbA1c), and the urinary microalbumin (MAlb)-to-urinary creatinine (uCr) ratio in the diagnosis of diabetic nephropathy (DN). Methods: A retrospective study design was employed. A total of 105 patients diagnosed with diabetic nephropathy (DN) at the Third People’s Hospital of Nanning from January 2023 to December 2025 were enrolled as study group A, and 118 patients with simple diabetes mellitus (DM) were enrolled as study group B. General data and levels of various detection indicators were compared between the two groups. Multivariate logistic regression was used to analyze the influencing factors for the occurrence of diabetic nephropathy in diabetic patients. Receiver operating characteristic (ROC) curves were plotted to analyze the predictive value of single and combined detection of Ur, Ua, Hcy, HbA1c, and MAlb/uCr for diabetic nephropathy. Results: The levels of Cr, Ur, Ua, Hcy, HbA1c, and MAlb/uCr in the diabetic nephropathy group were significantly higher than those in the simple diabetes group, with statistically significant differences (P < 0.05). Multivariate logistic regression analysis showed that elevated levels of Cr (OR = 1.028, 95% CI: 1.006 - 1.050) and MAlb/uCr (OR = 1.006, 95% CI: 1.003 - 1.009) were independent risk factors for the development of DN in DM patients (P < 0.05). ROC curve analysis showed that the area under the curve (AUC) for the combined detection of Ur, Ua, Hcy, HbA1c, and MAlb/uCr in predicting the development of DN in DM patients was 0.863, with a sensitivity of 77.10% and a specificity of 87.30%, which were superior to single detection of each indicator. Conclusion: Elevated levels of Cr and MAlb/uCr are independent risk factors for the development of diabetic nephropathy in diabetic patients. Combined detection of Ur, Ua, Hcy, HbA1c, and MAlb/uCr can significantly improve the diagnostic efficiency for diabetic nephropathy, providing an important laboratory basis for early clinical screening and intervention of diabetic nephropathy.