One of my colleagues was of the view that if there is co-existent azotemia with proteinuria then albumin to Cr ratio would be inaccurate because creatinine clearance will be reduced so urine Cr will be decreased and ratio will overestimate albumin (Cr being the denominator) and to get correct picture 24 hr urinary protein collection would be required. Is this true or the ratio still gives accurate picture even with reduced Cr clearance?