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🧪 Albumin-Creatinine Ratio (ACR) – Spot Urine Test

Parameter	Details
Test Name	Urine Albumin-to-Creatinine Ratio (ACR), Spot Sample
Sample Type	Random spot urine (usually first morning sample preferred)
Fasting Required?	❌ No fasting required
Normal Range	<30 mg/g (or mg/mmol)
Primary Purpose	Detect early kidney damage, especially in diabetes and hypertension
Organs Involved	Kidneys (glomeruli – filtration units)

🧠 What Does ACR Measure?

The ACR test compares:

Albumin – a protein that shouldn’t normally pass into urine in large amounts
Creatinine – a waste product used to normalize the concentration based on urine volume

By comparing albumin to creatinine, it adjusts for urine concentration, allowing accurate assessment from a single (spot) sample.

📊 Interpretation of ACR Results (mg/g)

ACR Range	Interpretation	Clinical Term
<30 mg/g	Normal	Normoalbuminuria
30–300 mg/g	Mild elevation – early kidney damage	Microalbuminuria
>300 mg/g	Significant kidney damage	Macroalbuminuria / Proteinuria

Note: Units may vary (mg/mmol vs mg/g); always compare with your lab’s reference range.

⚕️ When Is ACR Used?

Condition	Why It’s Done
Diabetes (Type 1 & 2)	Detect early diabetic nephropathy
Hypertension	Screen for hypertensive kidney damage
Chronic Kidney Disease (CKD)	Monitor progression of kidney damage
Heart disease risk	ACR is an independent predictor of cardiovascular disease

🩺 Further Tests Often Ordered With ACR

Test	Purpose
Serum Creatinine & eGFR	Evaluate kidney filtering ability
BUN (Blood Urea Nitrogen)	Another kidney function test
Urine Routine	Check for blood, protein, infection in urine
HbA1c	Monitor sugar control in diabetes
Blood Pressure Monitoring	Essential in kidney disease management
CRP / ESR	Detect inflammation that could affect the kidneys

🚩 What Causes Elevated ACR?

Cause Category	Examples
Kidney-related	Diabetic nephropathy, hypertensive nephropathy, glomerulonephritis
Cardiovascular-related	Heart failure, atherosclerosis
Infectious or Immune	Lupus, infections, sepsis
Temporary Causes	Fever, intense exercise, dehydration

✅ Summary Table

Test	Albumin-Creatinine Ratio (ACR)
Sample	Spot (random) urine sample
Organs Evaluated	Kidneys
Used For	Early detection of kidney disease
Key Populations	Diabetics, hypertensive patients, CKD patients
Actionable If High	Tighten blood sugar/pressure control, nephrologist referral

Albumin creatinine ratio (ACR) - Spot sample