albumin/creatinine in urine
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Indications
- evaluation of
* no need to monitor in patients taking ACE inhibitor or ARB[1]
Reference interval
- normal urine albumin: 2-30 mg/day
- generally measured relative to urine creatinine (normal Alb/Creat < 0.015)#
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
Specimen
- 1st voided morning urine specimen is best
Interferences
Drug interferences:
- NSAIDs may interfere with test
- ACE inhibitors may interfere with testing
Notes
- a calculation of urine albumin/creatinine ratio proposed using urine protein-creatinine ratios & protein-dipstick results[2]
More general terms
More specific terms
Additional terms
Components
References
- ↑ 1.0 1.1 1.2 Medical Knowledge Self Assessment Program (MKSAP) 11,18,19. American College of Physicians, Philadelphia 1998, 2018, 2021.
- ↑ 2.0 2.1 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: https://www.ncbi.nlm.nih.gov/pubmed/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: https://www.ncbi.nlm.nih.gov/pubmed/32658572 https://www.acpjournals.org/doi/10.7326/M20-4211
Urine Protein-Creatinine Conversion http://ckdpcrisk.org/pcr2acr/
Patient information
albumin in urine (albumin/creatinine, microalbumin) patient information