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Albumin/Creatinine Ratio

Blood Sciences Test


Random Urine (10 mls)

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mg/mmol creatinine

Reference Range

In Diabetes Mellitus:

  • ACR > 2.5 mg/mmol (men) or > 3.5 (women) suggests clinically significant microalbuminuria.

Without Diabetes Mellitus:

  • ACR > 30 mg/mmol suggests clinically significant proteinuria
  • ACR > 70 mg/mmol suggests heavy proteinuria.
  • If first sample, repeat to confirm.

Test Usage

Microalbumin is a test currently used only in diabetics where it is a marker for early nephropathy at a stage where it is reversible with good control of hypertension and hyperglycaemia. In Type 2 diabetes, it is a powerful risk marker for vascular disease.

The term microalbumin refers to ordinary albumin (not a tiny albumin) found in urine at concentrations below 300 mg/L, the cut-off point for conventional urine dipsticks. Concentrations above this are called macroalbuminuria/persistent proteinuria/clinical proteinuria and indicate irreversible nephropathy.

Because biological variance of urine microalbumin is high (± 50%) and because transient increases in microalbumin can be due to urinary tract infection, exercise, intercurrent illness etc, a first abnormal result should be followed by others over a 2-12 month period and include an MSU looking for UTI. The possibility of non- diabetic nephropathy also needs to be considered.

If the microalbumin concentration is greater than 400 mg/L, the laboratory auto-reflexes a protein/creatinine ratio.

Turnaround time

1 day


Local test

Can be added on to an existing request up to 4 days following sample receipt

Specimen Labelling Procedure
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