Urine Albumin Creatinine Ratio (ACR) Test 

A microalbumin creatinine ratio urine test checks the levels of the protein albumin in your urine (pee). Abnormal amounts of this protein may be an early sign of kidney disease.

In healthy kidneys, only trace amounts of albumin may pass through the filters in the kidneys. This trace is often called microalbumin. But if your kidneys are damaged, large amounts of albumin may pass into your urine.

Creatinine, on the other hand often appears in your urine. It is a waste product that comes from daily wear and tear on your muscles. Your kidneys usually remove this protein at a steady rate. The microalbumin creatinine ratio test compares the levels of albumin in your urine to your levels of creatinine. This ratio can help your health care provider tell if your body is getting rid of albumin at an increased rate.

Other names: albumin-creatinine ratio; urine albumin; microalbumin, urine; ACR; UACR

What is the Urine Albumin Creatinine Ratio Test (ACR) Used for?

The ACR test is mainly used to check for early signs of kidney disease, particularly in people who are at higher risk, such as those with diabetes, high blood pressure, or heart disease. Even small amounts of albumin in the urine can signal that the kidneys are not working properly.

The results are expressed as a ratio.

Why do I need a microalbumin creatinine ratio test?

Your doctor may recommend this test if you:

• Have diabetes (to monitor kidney health)
• Have high blood pressure
• Have a family history of kidney disease
• Show other signs of possible kidney problems, such as swelling in your hands, feet, or face

What happens during a microalbumin creatinine ratio test?

You’ll be asked to provide a small urine sample. In some cases, it may be collected as a random sample during the day, or your doctor may request an early morning sample. The sample is then sent to a laboratory to measure the levels of albumin and creatinine.

Will I need to do anything to prepare for the test?

Usually, no special preparation is needed however we advise you ideally avoid the following before your test to gain a more accurate result:

• Intense exercise. Hard exercise may increase the amount of albumin in your urine for a short time.
• Eating meat. Meat can affect your creatine levels, so you may be asked not to eat any for a day before your test.
• Being dehydrated
• Certain medications may affect the results, such as NSAIDs (ibuprofen, naproxen), Antibiotics, blood pressure medicines and water tablets, chemotherapy drugs so we advise you to please check with you doctor before performing the test.
• Avoid the test if you have a UTI or fever until your better as this can affect the results.

Are there any risks to the test?

No. This is a safe, non-invasive test that only requires a urine sample.

What do the results mean?

• Normal: ACR less than 30 mg/g – kidneys are filtering properly.
• Moderately increased (microalbuminuria): ACR between 30–300 mg/g – may indicate early kidney disease.
• Severely increased (macroalbuminuria): ACR above 300 mg/g – suggests more advanced kidney damage.

Your should share the results with your doctor who will discuss what the results mean for you and whether any further tests or treatment are needed.

Is there anything else I need to know about a microalbumin creatinine ratio test?

The test is often repeated to confirm results, as temporary factors like exercise, fever, or dehydration can affect albumin levels. Regular monitoring is especially important if you have diabetes or high blood pressure.