Albumin-Creatinine Ratio

The Albumin-Creatinine Ratio (ACR) is a medical test that measures the ratio of albumin, a protein, to creatinine, a waste product, in a person’s urine sample. It is used to assess kidney function and detect kidney damage or disease. The ACR test is particularly useful in screening for kidney problems in individuals with conditions such as diabetes or hypertension.

The ACR test is often performed on a random urine sample or a timed urine collection. It is a more sensitive indicator of kidney damage than measuring albumin levels alone. Normally, the kidneys filter out waste products like creatinine while retaining essential proteins like albumin. However, when the kidneys are not functioning properly, they may allow albumin to leak into the urine, resulting in an increased ACR.

Urine albumin to creatinine ratio (ACR), also known as urine microalbumin, helps identify kidney disease that can occur as a complication of diabetes.

Why is this test done :

This test helps your doctor see how well your kidneys are working. It is done most often to check the kidneys in people with diabetes or chronic kidney failure. It may also be done to check people with high blood pressure, heart failure, and cirrhosis.

When to get tested :

Annually after a diagnosis of diabetes or hypertension

Test Preparation :

• Tell your doctor if you are having your period or have vaginal discharge.
• Your doctor or the lab likely will give you the container you need to hold the urine. You will get instructions on when and how to collect the urine. This might be a one-time sample or a number of samples over a period of time.

Sample Required:

• The sample is urine.
• It is better to do three random samples for a week.
• The urine sample is stable at room temperature for up to 2 days and at 8 °C for up to 14 days.

Normal Value:

Source 1

• Albumin in urine < 30 mg/24 hours
• Or < 20 mg/day.
• Or < 20 mg/L (urine collected in 10 hours).

Source 2 

• 0.2 to 1.9 mg/dL     

 Abnormal value 

• Albumin > 30 mg/24 hours .
• Or > 20 mg/L (in 10 hours).

limits with various dipsticks:

• Albusure 2 to 3 mg/dl
• Micral 1.5 to 2 mg/dl
• Micro-Burnintest 4 to 8 mg/dl

Microalbuminuria Is Seen In:

• Diabetes mellitus.
• Myoglobinuria.
• Nephrotoxic drugs.
• Bence-Jones proteinuria.
• Hemoglobinuria.
• Any kind of Nephropathy.
• Hypertension.
• Myocardial infarction.
• Atherosclerosis ( Generalized vascular disease ).
• Lipid abnormalities.
• Pre-eclampsia.

FAQS:

What does an elevated albumin-to-creatinine ratio (ACR) indicate?

An elevated ACR suggests the presence of albuminuria, which is the presence of albumin in the urine. This can indicate kidney damage or dysfunction. It is commonly seen in conditions such as diabetes, high blood pressure, and kidney disease.

How is the albumin-to-creatinine ratio (ACR) test performed?

The ACR test is performed on a urine sample. It can be done on a random urine sample or a timed urine collection. The sample is analyzed in a laboratory to measure the levels of albumin and creatinine. The ratio is then calculated by dividing the amount of albumin by the amount of creatinine.

Is fasting required before the ACR test?

Generally, fasting is not required before the ACR test. It can be done at any time of the day and does not require any special preparation. However, it’s always best to follow the instructions provided by your healthcare provider or the laboratory where the test is being conducted.

Can medications affect the albumin-to-creatinine ratio (ACR) results?

Yes, certain medications can affect ACR results. For example, nonsteroidal anti-inflammatory drugs (NSAIDs) and certain blood pressure medications can temporarily increase ACR levels. It’s important to inform your healthcare provider about any medications or supplements you are taking before undergoing the test.

Can lifestyle factors influence the albumin-to-creatinine ratio (ACR)?

Yes, lifestyle factors can influence ACR results. Factors such as exercise, diet, and dehydration can affect the ratio. It is recommended to maintain normal fluid intake and follow a regular diet before the test to ensure accurate results.

How often should the albumin-to-creatinine ratio (ACR) be monitored?

The frequency of ACR monitoring depends on the individual’s medical condition and the recommendations of their healthcare provider. In general, individuals with diabetes or high blood pressure should have their ACR levels monitored at least once a year. Those with existing kidney disease or other risk factors may require more frequent monitoring.

Can the albumin-to-creatinine ratio (ACR) be used to diagnose specific kidney diseases?

The ACR test is not used to diagnose specific kidney diseases but rather to assess kidney function and detect kidney damage. If kidney damage is suspected based on the ACR results, further diagnostic tests, such as a kidney biopsy or additional imaging studies, may be required to determine the underlying cause of the kidney disease.

Can the albumin-to-creatinine ratio (ACR) be used to monitor the effectiveness of kidney disease treatment?

Yes, the ACR test is commonly used to monitor the effectiveness of treatment for kidney disease. By regularly measuring ACR levels over time, healthcare providers can assess the response to treatment, make adjustments if necessary, and evaluate the progression or regression of kidney damage.