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Urine Microalbumin-to-Creatinine Ratio

Immunology & Autoimmune

Microalbumin/creatinine ratioUACRUr Alb/CrUrine albumin-to-creatinine ratio

Review status

Currently under review

Pending specialist review and validation.

What it shows

The urine microalbumin-to-creatinine ratio measures the amount of albumin in a urine sample compared with creatinine. Albumin is a blood protein that healthy kidneys usually keep out of urine. Because urine concentration changes with fluid intake, expressing albumin relative to creatinine helps standardize the result from a single spot sample.

This test is collected from a clean-catch urine sample, often the first urine of the day. It is used to screen for early kidney damage and to monitor known kidney conditions in primary care and specialty settings.

Why it matters

This test helps detect early kidney injury before other tests change. It is particularly important if you have diabetes, high blood pressure, cardiovascular disease, or a family history of kidney problems. Finding albumin in urine can reflect stress or damage to the tiny filters in the kidneys.

Clinicians use the result to guide treatment, assess response to kidney-protective medicines, and estimate long-term risks related to heart and kidney health. It is commonly ordered at regular intervals in people at risk and alongside blood tests that assess how well the kidneys filter waste.

Understanding your results

Your clinician will interpret your result in the context of your age, sex, medical history, and current health. A higher value can be temporary due to recent vigorous exercise, fever, a urinary tract infection, menstruation, or dehydration. If the result is unexpectedly high, your care team may repeat the test after those factors have resolved to confirm whether it persists.

If elevation continues over time, your clinician may order additional tests, such as a repeat urine test, urine sediment evaluation, or blood tests that estimate kidney filtration, and may consider treatments that reduce kidney stress. Interpretation can differ in pregnancy, in children, and in people with known kidney conditions, so individualized follow up is important.

Reference ranges

03.4 mg/mmol
Female
0 days – 18 years
02.4 mg/mmol
Male
0 days – 18 years
02.7 mg/mmol
Female
18 years – 150 years
01.9 mg/mmol
Male
18 years – 150 years

Reference intervals vary by laboratory, analyzer, methodology, population, and units. The ranges shown here are for education only. Always interpret your results against the reference interval printed on your own lab report.

Factors that could impact Urine Microalbumin-to-Creatinine Ratio

  • Hydration and urine concentration

    Very concentrated or very dilute urine can influence the albumin and creatinine measurements. Aim for typical hydration and avoid excessive fluid intake right before the sample.

  • Recent exercise or illness

    Strenuous activity, fever, or an acute illness can temporarily increase albumin in urine. Avoid heavy exercise the day before collection and reschedule if you are acutely unwell.

  • Menstruation and contamination

    Menstrual blood or vaginal discharge can affect the result. If possible, avoid testing during menstruation and use a clean-catch, midstream technique to reduce contamination.

  • Medications and supplements

    Kidney-protective drugs such as ACE inhibitors, ARBs, and SGLT2 inhibitors can lower albuminuria, while some pain relievers like NSAIDs may affect kidney function. Tell your clinician about all prescription drugs and over-the-counter products.

  • Urinary tract conditions

    A urinary tract infection, kidney stones, or recent urologic procedures can raise albumin in urine. Testing is best done when these issues have resolved, or results may need confirmation later.

  • Sample timing and method

    A first morning, clean-catch, midstream specimen is often preferred. Follow collection instructions closely to improve accuracy and reduce the chance of a false elevation.

2026

References

  1. McGill University Health Centre. (2015, April 30). U Microalb/Cr Ratio (Task CD 793484). Laboratory reference ranges.
  2. Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. (2024). KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney International Supplements. External link
  3. American Diabetes Association. (2024). Standards of care in diabetes. Diabetes Care. External link