Two biomarkers — urinary albumin to creatinine ratio (ACR) and estimated glomerular filtration rate — are used to identify those at higher risk of kidney failure. But many say those criteria miss a large proportion of patients who are at high risk of the disease and fail to predict accurately time of onset of ESRD. Now a research team has developed a prognostic tool that accurately predicts the risk of end stage renal disease (ESRD) in patients with both type 1 and type 2 diabetes.