Renal function
Urine albumin/creatinine ratioUACR
Glomerular permeability marker; the earliest indicator of diabetic and hypertensive nephropathy.
Sample
Spot urine, ideally first-morning
Clinical reference range
— to 30 mg/g
Normoalbuminuria
Conv: —–30 mg/g
Biology
What it measures
Albumin (66 kDa) is normally restricted by glomerular size and charge. Damage to the glomerular barrier permits leakage.
Clinical use
Why we order it
Annual screening in diabetes and hypertension; CKD staging.
Lens · Clinical
Interpretation by lens
Clinical interpretation
30–300 mg/g = moderately increased (formerly 'microalbuminuria'); >300 = severely increased.
Differential
Causes of abnormal values
Causes of HIGH
- ↑Diabetic nephropathy
- ↑Hypertensive nephropathy
- ↑Glomerulonephritis
- ↑Heart failure
- ↑Recent strenuous exercise (transient)
- ↑UTI
Pitfalls
Pre-analytic & interpretation traps
- !Confirm with two of three positive samples over months; avoid measurement during UTI, menses, or after vigorous exercise.
Follow-up orders
Logical next-step labs
Related