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, 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.

The National Kidney Foundation recommends that Type 2 diabetics under the age of 70 and Type 1 diabetics over the age of 12 be screened annually for microalbuminuria. In addition, microalbumin may be ordered when a person is first diagnosed with Type 2 diabetes. According to the American Diabetes Association, in Type 1 diabetes, annual testing should begin 5 years after diagnosis.

Patients with hypertension may be tested at regular intervals, with the frequency determined by their doctor.

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.

Recently, studies have shown that in Type 2 diabetics, an abnormal microalbumin result indicates an increased risk of developing cardiovascular disease (CVD).