Millner RO, et al. - Catheterized urine was collected from 40 individuals with neurogenic bladder (NGB) at a tertiary pediatric hospital in order to examine the role of albuminuria as a clinical marker of early renal disease in children with NGB in relation with generally used predictors of renal risk. Increased albumin-to-creatinine ratio (ACR) ≥ 30 mg/g was noted in about 32 of NGB patients, which was correlated with Caucasian race, clean intermittent catheterization, hydronephrosis, and vesicoureteral reflux on univariate analysis. In multivariable analysis, important predictors of ACR elevation were the presence of vesicoureteral reflux and the use of anticholinergic medication. Thus, albuminuria is an authorized clinical predictor of renal disease and risk for progression to renal failure. In individuals with NGB, with urinary tract abnormalities, the presence of albuminuria implies these patients may be at heightened risk for progressive renal disease. This promotes the clinical use of adding ACR to the assessment of renal risk in pediatric NGB.