Microalbumin and
Microalbumin/Creatinine Ratio
Also known as: Urine microalbumin; Albumin-to-Creatinine ratio; ACR
Formal name: Microalbumin and Microalbumin/Creatinine Ratio
The Test
How is it used?
The random microalbumin test or microalbumin/creatinine ratio is frequently ordered as a screening test on patients with chronic conditions, such as diabetes and hypertension, that put them at an increased risk of developing kidney failure. Studies have shown that identifying the very early stages of kidney disease (microalbuminuria) helps patients and doctors adjust treatment. With better control of diabetes and hypertension by maintaining tight glycemic control and reducing blood pressure, the progression of diabetic kidney disease can be slowed or prevented.
A timed microalbumin test (4 hour or overnight) may be ordered as an alternative screening tool. If significant amounts of microalbumin are detected with these screening tests, they may be confirmed with a 24-hour microalbumin test.
When is it ordered?
The National Kidney Foundation recommends that everyone with diabetes between 12 and 70 years of age have a urine test for microalbuminuria at least once a year. According to the American Diabetes Association, everyone with type 1 diabetes should get tested annually, starting 5 years after onset, and all those with type 2 diabetes should start at the time of diagnosis. If microalbuminuria is detected, it should be confirmed by retesting and, if positive on 2 of 3 determinations over a 3-6 month period, it is considered to be present and appropriate treatment should be given.
Patients with hypertension may be tested at regular intervals, with the frequency determined by their doctor.
What does the test result mean?
Moderately increased microalbumin levels in urine indicate that a person is in one of the very early phases of developing kidney disease. Very high levels are an indication that kidney disease is present in a more severe form. Normal levels are an indication that kidney function is normal.
Is there anything else I should know?
Studies have shown that elevated levels of urinary albumin in people with diabetes or hypertension are associated with increased risk of developing cardiovascular disease (CVD), even if those levels are within the normal reference range. More recently, research has been focused on trying to determine if increased levels of albumin in the urine are also indicative of CVD risk in those who do not have diabetes or high blood pressure.
