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🧪 What is the Microalbumin/Creatinine Ratio – Spot Urine Test (ACR)?

The Albumin-to-Creatinine Ratio (ACR) in a spot urine sample is a convenient and sensitive method to detect microalbuminuria, which signals early kidney damage, especially in individuals with diabetes, hypertension, or chronic kidney disease (CKD).

It adjusts albumin concentration for variations in urine concentration using creatinine.
Ideal for screening and monitoring kidney health without requiring 24-hour collection.

❓ Why is the Test Done?

To:

Screen for early kidney disease in diabetic or hypertensive patients
Detect microalbuminuria before serum creatinine or GFR changes
Monitor renal function over time
Guide treatment decisions to prevent nephropathy progression
Assess cardiovascular risk (as albuminuria is a known marker)

📊 Normal Range & Interpretation

ACR (mg/g creatinine)	Interpretation
< 30 mg/g	Normal – no significant protein loss
30–300 mg/g	Microalbuminuria – early kidney damage
> 300 mg/g	Macroalbuminuria – advanced nephropathy

At least 2 out of 3 tests over 3–6 months are needed to confirm persistent microalbuminuria.

📈 Interpretation of Results

Result Range	Meaning
< 30 mg/g	Normal kidney filtration
30–300 mg/g	Early glomerular damage; intervention can reverse or delay CKD
> 300 mg/g	Overt nephropathy; may indicate progression to Stage 3–5 CKD

🧠 Associated Organs & Conditions

Organ/System	Associated Conditions
Kidneys	Diabetic nephropathy, hypertensive nephrosclerosis, glomerulonephritis
Cardiovascular	Atherosclerosis, heart failure risk
Endocrine	Type 1 & Type 2 Diabetes
Pregnancy	Preeclampsia (in high-risk pregnancies)

🔄 Related / Follow-Up Tests

Serum Creatinine & eGFR – kidney function
HbA1c – blood glucose control in diabetics
Urinalysis – for RBCs, WBCs, casts, or protein
24-hour Urine Albumin or ACR – for confirmation
Blood Pressure Monitoring
Lipid Profile – assess cardiovascular risk

✅ Fasting Required?

Test	Fasting Required
ACR – Spot Urine	❌ Not required

Preferred sample: First morning urine
Avoid testing during: fever, UTI, menstruation, or after heavy physical activity

📝 Summary Table

Parameter	Details
What	Measures ratio of albumin (mg) to creatinine (g) in spot urine
Why	Detect early kidney damage in high-risk individuals
Normal Range	< 30 mg/g creatinine
Microalbuminuria	30–300 mg/g – early nephropathy
Macroalbuminuria	> 300 mg/g – advanced protein loss
Associated Conditions	Diabetes, CKD, hypertension, cardiovascular risk
Follow-up Tests	eGFR, HbA1c, BP, 24-hour albumin, lipid profile
Fasting Required	❌ No

Microalbumin creatinine ratio- Spot Urine

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