jamunjar-logo
whatsapp
cartmembermenu
Search for
"test & packages"
"physiotherapy"
"heart"
"lungs"
"diabetes"
"kidney"
"liver"
"cancer"
"thyroid"
"bones"
"fever"
"vitamin"
"iron"
"HTN"

Albumin creatinine ratio (ACR) - Spot sample

Kidney
image

Report in 4Hrs

image

At Home

nofastingrequire

No Fasting Required

Details

Albumin-Creatinine Ratio (ACR) test based on a spot urine sample—a vital tool for early detection of kidney disease

₹699₹900

22% OFF

Albumin Creatinine Ratio (ACR) - Spot Sample

  • Why is it done?
    • Measures the concentration of albumin (a protein) in urine relative to creatinine (a waste product), which helps detect early signs of kidney disease and proteinuria
    • Screens for diabetic nephropathy in patients with type 1 or type 2 diabetes mellitus
    • Assesses kidney function and early kidney damage in hypertensive patients
    • Detects microalbuminuria (early stage of protein excretion) before clinical proteinuria develops
    • Monitors progression of chronic kidney disease and response to treatment
    • Typically performed as part of routine screening in diabetic patients and those with cardiovascular risk factors
  • Normal Range
    • Normal (Negative): <30 mg/g creatinine or <3.4 mg/mmol creatinine
    • Microalbuminuria (Early kidney disease): 30-300 mg/g creatinine or 3.4-34 mg/mmol creatinine
    • Macroalbuminuria (Advanced kidney disease): >300 mg/g creatinine or >34 mg/mmol creatinine
    • Units of measurement: mg/g creatinine (milligrams per gram of creatinine) or mg/mmol creatinine (milligrams per millimole of creatinine)
    • Values above 30 mg/g are considered abnormal and indicate protein (albumin) is being lost in the urine at a rate higher than normal
    • The spot sample provides a single point-in-time measurement; may require repeat testing to confirm results due to day-to-day variation
  • Interpretation
    • ACR <30 mg/g (Normal): Indicates normal kidney function with minimal or no albumin excretion. Kidney filtration is working properly and albumin is being retained in the blood where it belongs.
    • ACR 30-300 mg/g (Microalbuminuria): Suggests early kidney disease or early diabetic nephropathy. This is an important indicator that kidney damage is beginning. In diabetic patients, this stage is potentially reversible with appropriate intervention. This finding warrants aggressive management of blood glucose, blood pressure, and initiation or optimization of renal-protective medications.
    • ACR >300 mg/g (Macroalbuminuria): Indicates substantial kidney disease or advanced diabetic nephropathy. This level of proteinuria is associated with more significant kidney damage and may indicate progression toward kidney failure. Requires immediate clinical attention and intensive management.
    • Factors affecting ACR readings: Urinary tract infections, vigorous exercise, fever, menstruation, dehydration, and uncontrolled hypertension can falsely elevate results. Standardized first morning void specimens are preferred for consistency.
    • Spot sample considerations: The spot urine sample (random timing) is convenient but subject to physiological variation. First morning urine is most standardized. At least 2-3 positive results over 3-6 months are typically needed to confirm microalbuminuria diagnosis, as single elevated values may represent transient elevation.
    • Clinical significance: ACR is a predictor of progression to overt proteinuria, chronic kidney disease, and increased cardiovascular risk. Even mild elevations in ACR in diabetic patients are associated with increased mortality and morbidity.
  • Associated Organs
    • Primary organ: Kidneys - This test directly assesses kidney filtration function and glomerular integrity. The glomerulus (filtering unit of the kidney) becomes abnormally permeable, allowing albumin to leak into urine.
    • Associated medical conditions with abnormal ACR:
    • Diabetic nephropathy (kidney disease secondary to diabetes mellitus)
    • Hypertensive nephropathy (kidney damage from chronic high blood pressure)
    • Chronic kidney disease (CKD) - Stages 1-3
    • IgA nephropathy and other primary glomerulonephropathies
    • Systemic lupus erythematosus (SLE) and other autoimmune kidney diseases
    • Polycystic kidney disease
    • Cardiovascular disease and metabolic syndrome
    • Potential complications associated with abnormal results:
    • Progressive decline in glomerular filtration rate (GFR)
    • End-stage renal disease (ESRD) requiring dialysis or transplantation
    • Significantly increased cardiovascular morbidity and mortality
    • Hypertension progression and worsening blood pressure control
    • Electrolyte abnormalities (sodium, potassium, phosphate retention)
  • Follow-up Tests
    • If microalbuminuria (ACR 30-300 mg/g) is detected:
    • Repeat ACR testing (2-3 additional times over 3-6 months to confirm diagnosis before initiating treatment)
    • Serum creatinine and estimated glomerular filtration rate (eGFR) calculation
    • Blood urea nitrogen (BUN) assessment
    • Serum electrolytes (sodium, potassium, chloride, bicarbonate) to assess for renal insufficiency
    • 24-hour urine protein and creatinine collection (gold standard for proteinuria quantification)
    • Fasting blood glucose and HbA1c (hemoglobin A1c) in diabetic patients
    • Blood pressure monitoring and cardiovascular risk assessment
    • If macroalbuminuria (ACR >300 mg/g) is detected:
    • Urgent referral to nephrology (kidney specialist)
    • Comprehensive metabolic panel including serum creatinine, BUN, electrolytes, and eGFR
    • Lipid panel to assess cardiovascular risk
    • Renal ultrasound or imaging to assess kidney structure and rule out obstruction
    • Consideration of renal biopsy if diagnosis is unclear or atypical presentation
    • Monitoring frequency:
    • Normal ACR: Annually or per clinical guidelines for at-risk populations
    • Microalbuminuria: Every 3-6 months during diagnostic confirmation and initial treatment phases; then at least annually for monitoring
    • Macroalbuminuria: Every 3 months to monitor progression and treatment response
    • Related complementary tests:
    • Cystatin C (alternative marker of GFR, less affected by muscle mass)
    • Urine dipstick for blood, glucose, and other abnormalities
    • Urinalysis and urine microscopy to detect cells, casts, and infections
    • Antinuclear antibody (ANA) and other serologic tests if autoimmune kidney disease is suspected
  • Fasting Required?
    • Fasting Required: No
    • Patient preparation:
    • Food and fluid intake do not need to be restricted; fasting status does not affect ACR results
    • Routine medications should be taken as normally prescribed; do not discontinue medications
    • Special instructions and considerations:
    • First morning urine specimen is preferred when possible, as it is the most concentrated and standardized
    • Collect mid-stream clean-catch urine specimen to avoid contamination from genital flora
    • At least 30 mL of urine is typically required for accurate analysis
    • Avoid vigorous exercise for 24 hours before testing, as intense exercise can transiently elevate urinary albumin
    • Postpone testing if patient has acute urinary tract infection, fever, or menstruation, as these can falsely elevate results
    • Maintain adequate hydration throughout the day (normal water intake)
    • Follow laboratory's specific collection container and handling instructions if provided
    • Deliver specimen to laboratory promptly (within 2 hours if unrefrigerated, or refrigerate if delay is expected)
    • No specific medications need to be avoided, but inform healthcare provider of all current medications as some may affect kidney function or results interpretation

How our test process works!

customers
customers