🧪 What is Microalbumin/Creatinine Ratio – 24-Hour Urine?

This test measures the ratio of albumin to creatinine in a 24-hour urine sample to evaluate early kidney damage, particularly in patients with diabetes, hypertension, or chronic kidney disease (CKD).

• The albumin level indicates kidney leakage.
• The creatinine level adjusts for urine concentration.
• The ratio improves accuracy over measuring albumin alone.

While spot ACR is more commonly used for screening, 24-hour ACR provides a more precise measure when needed.

❓ Why is the Test Done?

To:

• Detect early kidney disease (microalbuminuria) in diabetes, hypertension, and CKD
• Confirm abnormal results from spot ACR tests
• Evaluate albumin excretion over time
• Assess risk of cardiovascular disease and progression of nephropathy

📦 How the Test is Done

• Urine is collected over a full 24-hour period
• Total albumin (mg/day) and total creatinine (g/day) are measured
• The ACR is calculated as:
  ACR (mg/g) = Total Albumin (mg) ÷ Total Creatinine (g)

📊 Normal Range & Interpretation

Repeated values in the 30–300 mg/g range on 2 of 3 tests over 3–6 months indicate early nephropathy.

📈 Result Interpretation

🧠 Associated Organs & Conditions

🔄 Related / Follow-Up Tests

• Serum Creatinine and eGFR – for kidney function
• Spot ACR – for routine monitoring
• Urine Routine & Microscopy
• HbA1c – for glycemic control
• Blood Pressure – close monitoring
• Lipid Profile – cardiovascular risk evaluation

✅ Fasting Required?

💡 Patient must follow strict 24-hour urine collection protocol:

• Discard first morning sample
• Collect all urine for the next 24 hours
• Store samples in a cool place
• Avoid collection during fever, menstruation, or UTI

📝 Summary Table