Albumin-Creatinine Ratio (ACR) URINE / SERUM

Albumin-Creatinine Ratio (ACR) Test – Detailed Guide

The Albumin-Creatinine Ratio (ACR) test is a urine test used to detect early kidney disease, especially in people with diabetes, high blood pressure, or other risk factors. It measures the amount of albumin (a type of protein) in the urine compared to creatinine (a waste product) to assess kidney function.

Why is the ACR Test Done?

This test helps detect albuminuria (protein in urine), which is an early sign of kidney damage. It is recommended for:

✅ Diabetes – To monitor for diabetic kidney disease (diabetic nephropathy)
✅ Hypertension (High Blood Pressure) – To assess kidney function
✅ Chronic Kidney Disease (CKD) – To track disease progression
✅ Heart Disease Risk Assessment – Since kidney damage increases heart disease risk
✅ Autoimmune Conditions (e.g., Lupus, Glomerulonephritis) – To check for kidney involvement

Test Procedure

1. Sample Collection:

   • A random urine sample (spot test) is commonly used
   • A 24-hour urine collection may be done in special cases
   • A first-morning urine sample is preferred for accuracy

2. Measurement:

   • Albumin (mg/dL) and Creatinine (mg/dL) levels are measured
   • The ratio is calculated (mg of albumin per gram of creatinine)

ACR Test Result Interpretation

What Do Abnormal ACR Levels Mean?

🔴 Elevated ACR (>30 mg/g) may indicate:

• Diabetic kidney disease (DKD)
• High blood pressure-related kidney damage
• Chronic kidney disease (CKD)
• Glomerulonephritis (inflammation of kidney filters)
• Urinary tract infections (UTI) or dehydration (temporary increase)

✅ Low ACR (<30 mg/g) is normal and suggests healthy kidney function.

Next Steps If ACR Is High

• Repeat the test after 3 months to confirm results
• Control blood sugar (diabetes) and blood pressure
• Lifestyle changes: low-salt diet, protein moderation, and hydration
• Medications like ACE inhibitors or ARBs may be prescribed to protect the kidneys