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albumin/creatinine in urine

Indications: - evaluation of - diabetic nephropathy* - proteinuria - microalbuminuria * no need to monitor in patients taking ACE inhibitor or ARB [1] Normal range: - normal urine albumin: 2-30 mg/day - generally measured relative to urine creatinine (normal Alb/Creat < 0.015)# Specimen: - 1st voided morning urine specimen is best Clinical significance: - quantitation of albumin cannot be done by the usual dipstick or quantitative protein methods - measurement small amount of albumin in the urine requires a sensitive immunoassay technique. - albumin in urine correlates with glomerular disease - absence of albumin in urine excludes most glomerular disease - greatest clinical value is detecting earliest manifestation of diabetic nephropathy (Alb/Creat > 0.030)# - random urine albumin/creatinine correlates with 24 hour urine albumin/creatinine [1] # Albumin & Creatinine in same units. - 0.015 is equivalent to 15 mg Albumin/g Creatinine - 0.030 is equivalent to 30 mg Albumin/g Creatinine Microalbuminuria is 0.30 > Alb/Creat > 0.030 Macroalbuminuria is Alb/Creat > 0.30 Increases: - glomerulopathy - diabetic nephropathy - proteinuria - microalbuminuria Interferences: Drug interferences: 1) NSAIDs may interfere with test 2) ACE inhibitors may interfere with testing Notes: - a calculation of urine albumin/creatinine ratio proposed using urine protein-creatinine ratios & protein-dipstick results [2]

Related

albumin (ALB) albumin in urine creatinine in urine microalbuminuria proteinuria

Specific

albumin/creatinine in 24 hour urine microalbumin/creatinine in urine

General

urine creatinine ratio

References

  1. Medical Knowledge Self Assessment Program (MKSAP) 11,18,19. American College of Physicians, Philadelphia 1998, 2018, 2021.
  2. Sumida K et al Conversion of Urine Protein-Creatinine Ratio or Urine Dipstick Protein to Urine Albumin-Creatinine Ratio for Use in Chronic Kidney Disease Screening and Prognosis. An Individual Participant-Based Meta-analysis. Annals of Internal Medicine. July 14, 2020 PMID: 32658569 https://www.acpjournals.org/doi/full/10.7326/M20-0529 - Harrison TG et al From Proteinuria to Albuminuria: Great Expectations for Kidney Failure Risk Prediction. Annals of Internal Medicine. July 14, 2020 PMID: 32658572 https://www.acpjournals.org/doi/10.7326/M20-4211 - Urine Protein-Creatinine Conversion http://ckdpcrisk.org/pcr2acr/

Components

albumin in urine creatinine in urine