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Albumin-Creatinine ratio (ACR)

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Albumin Creatinine Ration (ACR)

The albumin-creatinine ratio (ACR) is a diagnostic test that measures the amount of albumin (a protein) in the urine relative to creatinine (a waste product filtered by the kidneys). This ratio provides critical insights into kidney health and function.

What Does the ACR Indicate?

  1. Kidney Health:

    • Healthy kidneys typically prevent significant amounts of albumin from entering the urine. A low ACR (<30 mg/g) indicates normal kidney function[1][2].

    • Elevated ACR levels suggest albumin leakage into the urine, which is often a sign of kidney damage or disease (albuminuria or proteinuria)[3][4][5].

  2. Early Detection of Kidney Disease:

    • The test can detect early kidney damage, even before symptoms appear, making it useful for diagnosing chronic kidney disease (CKD)[4][6].

    • ACR levels between 30–300 mg/g indicate moderately increased albuminuria, while levels above 300 mg/g suggest severe kidney damage[2][7].

  3. Associated Conditions:

    • High ACR levels are commonly linked to conditions such as diabetes, hypertension, and cardiovascular diseases[8][6].

    • Persistent elevation in ACR can increase risks for kidney failure, heart attack, and stroke[1][5].

  4. Monitoring Disease Progression:

    • The test helps track kidney disease progression and evaluate the effectiveness of treatments over time[7].

Why Is ACR Important?

  • Unlike other kidney function tests (e.g., estimated glomerular filtration rate or eGFR), ACR is not influenced by muscle mass, providing a more accurate picture of kidney health[4].

  • Early intervention based on ACR results can slow disease progression and reduce complications such as high blood pressure and cardiovascular problems[3][8].

Interpreting Results

ACR Level

Interpretation

<30 mg/g

Normal kidney function

30–300 mg/g

Moderately increased albuminuria (early CKD)

>300 mg/g

Severely increased albuminuria (advanced CKD)



Next Steps

  • Elevated ACR results often require confirmation through repeat testing over several months to rule out temporary factors like exercise or inflammation[6][7].

  • Lifestyle changes, such as managing blood pressure, controlling diabetes, and following a kidney-friendly diet, can help improve ACR levels[3][8].

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  1. https://my.clevelandclinic.org/health/diagnostics/urine-albumin-creatinine-ratio

  2. https://www.kidney.org/kidney-topics/urine-albumin-creatinine-ratio-uacr

  3. https://mitohealth.com/blog/urine-albumin-creatinine-ratio-kidney-health-disease

  4. https://www.kidneyfund.org/resource/all-about-kidneys/tests-kidney-disease/urine-test-uacr

  5. https://www.kidney.org/kidney-failure-risk-factor-urine-albumin-creatinine-ratio-uacr

  6. https://medlineplus.gov/lab-tests/microalbumin-creatinine-ratio/

  7. https://www.testing.com/tests/urine-albumin-and-albumin-creatinine-ratio/

  8. https://www.nhs.uk/conditions/acr-test/