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Urine Albumin Creatinine Ratio (ACR)

Specimen Required

Urine (Random/Spot)

Fasting Required

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Purpose of the Test

To be screened for the early detection of kidney disease occurring as a complication of diabetes or hypertension (high blood pressure)

When this test is required

ACR should be requested when diabetes is first diagnosed. It is then usually measured annually or more frequently if significantly raised ACR values are found.

What the Test Detects

Albumin is a protein that is present in the blood. When the kidneys are working properly, only tiny amounts of albumin pass from the bloodstream into the urine. In kidney failure (the last stage of a slow process of decline in kidney function) large amounts of protein leak into the urine. A long time before this amount of damage, small changes in the kidney allow very small, but abnormal amounts of albumin to leak through, often as a result of having diabetes. Too little albumin is present to be detected by the usual simple urine test strip (sometimes called a protein dipstick). This is termed microalbuminuria because of the low but significant concentration of albumin in the urine, not because it is a smaller type of the protein. Microalbuminuria is usually simply called albuminuria.See MoreSee Less

Preparation for the Test

None

Sample Requirements

A urine sample. You will be asked to collect either an early morning or random sample of urine in which albumin and creatinine will be measured. The results are expressed as an albumin/creatinine ratio or ACR for short. The use of this ratio allows the albumin concentration to be related to the dilution of urine (as indicated by the creatinine concentration) which can depend on how much fluid you have consumed that day. ACR measurement in random urine samples has been shown to be just as good as the measurement of albumin alone in 24 hour urine samples and is much more convenient for the person being tested.

Additional Notes

Recent studies have shown that in patients with Type II diabetes, an abnormal ACR result indicates an increased risk of developing heart and blood vessel disease.