Albumin/Creatinine ratio
Investigation : Albumin/Creatinine ratio
Specimen type : Urine (random)
Spec container : Universal Container 
Volume required : 10ml
MALE Ref range : Null mg/mmol
FEMALE Ref range : Null mg/mmol
Turnaround : <72 hours

Albumin:Creatinine (ACR) measurement is the recommended first line test for proteinuria detection (NICE CG182,2014).

In diabeticsACR >2.5 mg/mmol in men and >3.5 mg/mmol in women is considered clinically significant
In non-diabeticsACR >3 mg/mmol (confirmed) is considered clinically significant.See link.

Heavy proteinuria
ACR >70 mg/mmol (approx equivalent to PCR of >100 mg/mmol, 1gm/day)

Initial detection of proteinuria
If ACR >3 mg/mmol but <70 mg/mmol this should be confirmed by a subsequent early morning sample.
If initial ACR is >70 mg/mmol (or PCR >100 mg/mmol) a repeat sample is not required.

Additional information:

Mersey Renal Units

NICE CKD Guidance - July 2014. Chronic kidney disease in adults: assessment and management

Additional information on microalbumin and its clinical use can be found here: microalbumin.

Additional information on urine albumin creatinine ratio and its clinical use can be found here: urine albumin creatinine ratio.

ICE requesting info:ICE panel nameICE page nameColumnComment\Advice
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