Test Detail
Interpreting Results

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Written by
Dr. Betina Chandolia
BDS, MDS - Oral Pathology and Microbiology
Reviewed by
Dr. Ashish Ranjan
MBBS, MD (Pharmacology)
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Microalbumin/Creatinine Ratio

Microalbumin/Creatinine Ratio
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This test is for
Male, Female
Test Preparation
  1. No special preparation required


What is Microalbumin/Creatinine Ratio?

The Microalbumin/Creatinine ratio urine test involves measuring the amount of albumin in the urine and then comparing it with creatinine produced. Microalbumin/Creatinine ratio is thus a very useful laboratory test to detect early kidney damage in people who are at risk of developing kidney disease.

Why is Microalbumin/Creatinine Ratio done?

The microalbumin/creatinine ratio is done:

  1. To detect early kidney disease in patients with diabetes or other risk factors, such as high blood pressure (hypertension)

  2. As routine health checkup for patients of hypertension and type 1 or 2 diabetes

What does Microalbumin/Creatinine Ratio Measure?

Usually, albumin and creatinine tests are done randomly (not timed) on a urine sample, and the results are used to calculate an albumin/creatinine ratio (ACR). This test gives a more accurate indication of how much albumin is being released into the urine.

The healthy kidneys keep healthy components such as albumin and filter waste from the blood. In case of kidney damage, albumin can leak through the kidneys and exit the body through urine. 

In case of any damage caused to the kidney, albumin is one of the first proteins to leak through the kidney. This test is recommended in those patients who are at increased risk of kidney disease or damage such as patients with type 1 diabetes, type 2 diabetes, or high blood pressure. 

Creatinine is a byproduct of muscle metabolism. Normally, it is released into the urine at a constant rate. The level of creatinine in the urine is an indication of the urine concentration. Thus, creatinine measurement can be used to indicate correct urine concentration when measuring albumin in a random urine sample.

The presence of a small amount of albumin in the urine can be an early indicator of kidney disease. The term ‘microalbuminuria’ is referred to a condition in which a small amount of albumin is present in the urine, while the term ‘albuminuria’ refers to a condition where there is presence of any amount of rise in albumin levels in the urine.

Interpreting Microalbumin/Creatinine Ratio results



Creatinine value in mg/dl





The results are interpreted as microalbumin:creatinine ratio in mg/g


Reference range in mg/g creatinine

Normal / Non-diabetic

< 30


30 - 300

Clinical albuminuria

> 300

Reference range may vary from lab to lab*

Three samples should be collected within 3-6 months, from which at least two should be abnormal to consider for diagnosis. 

Answers to Patient Concerns & Frequently Asked Questions (FAQs) about Microalbumin/Creatinine Ratio

Frequently Asked Questions about Microalbumin/Creatinine Ratio

Q. What are the risk factors which can lead to microalbuminuria?
The risk factors include being overweight, smoking, having a family history of diabetes, and kidney problems.
Q. What are the symptoms of microalbuminuria?
The symptoms of microalbuminuria do not appear at the early stages. Symptoms usually appear at late stages when the kidneys stop working properly. The symptoms include changes in urine, changes in the skin, and puffiness.
Q. How is the urine sample collected?
As the test is performed on the urine sample. It is essential to prevent contamination of the sample with microorganisms naturally present on the skin. During urine collection, women should spread the labia (outer lips of the vagina) while men should retract or pull back the foreskin (fold of skin covering the glans or head of the penis). Start urinating normally and let some urine flow before collecting 20 to 30 ml urine the sterilized container available from the lab or any pharmacy. After collecting the sample, finish urinating into the toilet or urinal. This process is called midstream clean catch method. The urine sample may also be collected using a catheter inserted through the urethra directly into the urinary bladder. Sample collected through a catheter usually has no contamination.
Q. Which factors can cause higher than expected urinary microalbumin results?
The factors which can cause higher than expected urinary microalbumin results include hematuria (blood in urine), certain medicines, fever, recent vigorous exercise, urinary tract infection, and other kidney diseases.
Q. What is microalbuminuria?
Microalbuminuria is a condition where the levels of albumin protein in urine are more than normal. It is an early sign of kidney problems. The risk of developing microalbuminuria increases in the case of diabetic and hypertensive patients. The patients having microalbuminuria are also at increased risk of having heart disease.
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