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This table provides a concise summary of the albuminuria and the Albumin-to-Creatinine Ratio (ACR) along with related investigations and guidelines as recommended by NICE
| Aspect | Explanation |
|---|---|
| Definition | Albuminuria is increased excretion of urinary albumin, a marker of kidney damage. |
| Importance | Principal early and sensitive marker in many kidney diseases. |
| ACR Calculation | Dividing albumin concentration (mg) by creatinine concentration (g) in a spot urine sample. |
| Investigation | Preferred method: Urinary ACR in spot urine sample. Not reagent strips, unless capable of measuring albumin at low concentrations and presenting results as ACR. |
| ACR Levels | - < 3 mg/mmol: No proteinuria, no action needed. - Between 3 and 70 mg/mmol: Repeat test in 3 months. - 70 mg/mmol or more: Significant proteinuria, no repeat test needed. |
| Notes | - PCR can be an alternative to ACR if ACR ≥ 70 mg/mmol. - Don't use a urine dipstick for proteinuria unless it can present result as ACR. - Transient increases in urine ACR can be due to various reasons like UTIs, menstruation, etc. - Offer CKD testing if unexplained proteinuria is found on a reagent strip. |
References
1 ACR | National Kidney Foundation
2 Initial investigations | Diagnosis | Chronic kidney disease | CKS | NICE...
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