[2008, amended 2014] 3 -30 mg/mol (moderately increased) [2008, amended 2014] 1.1.19 For the initial detection of proteinuria, if the ACR is between 3 mg/mmol and 70 mg/mmol, this should be confirmed by a subsequent early morning sample. Reducing urine albumin to the normal or near-normal range may improve renal and cardiovascular prognoses. If the first positive urine ACR is a random spot (as it may be for opportunistic testing), then repeat tests should ideally be first morning void specimens. Assess urine albumin excretion yearly to diagnose and monitor kidney damage in patients with type 1 diabetes for five years or more or with type 2 diabetes. An ACR below 30 is considered normal. The upper limit of normal range for microalbumin is the maximum value for normoalbuminuria. In Evaluating Patients with Diabetes for Kidney Disease. An ACR between 30-300 means you have moderately increased albuminuria. Albuminuria means that there is more albumin in the urine than there should be, which means the kidneys can be damaged. Urine ACR >30.0 mg/mmol: Severely increased* *Including nephrotic syndrome (urine ACR usually >220 mg/mmol) (according to NICE clinical guideline 182) Interpretation of raised urine ACR: Urine ACR 3.0 - 30.0 mg/mmol: Moderately increased. Urine albumin (mg/dL) ~ = UACR in mg/g ~ Albumin excretion in mg/day Urine creatinine (g/dL) … If the initial ACR is 70 mg/mmol or more, a repeat sample need not be tested. GFR ( ml/min/1.73 m^2) and ACR categories and risk of adverse outcomes: A1 < 3 mg/mol (normal to mildly increased) A2 . Albuminuria is the presence of albumin in the urine and a marker of kidney damage. The two key markers for chronic kidney disease (CKD) are urine albumin and estimated glomerular filtration rate (eGFR). ACR is the recommended method for people with diabetes. ALBUMIN/CREATININE RATIO (ACR) Definition The Albumin/Creatinine ratio (ACR) test result is a the ratio of measured albumin (a protein) and creatinine (a metabolism by-product) in the urine that has been excreted from the body, at the time of the test (spot sample). If your results show a small amount of albumin, you may have to repeat the test using a 24-hour urine sample to confirm the results. Results for ACR are given in milligrams per gram (mg/g). Shrimpton P., “Assessment of Patient Dose in CT” in Bongart G.Z., Golding S.J., Jurik A.G., et al., European Guidelines for Multislice Computed Tomography, 2004. Kidney damage stage is categorised into 3 stages based on urine ACR. Normal results are: MA: 0.2 to 1.9 mg/dL. ACR: 0 to 30 mg/g. ACR is calculated by dividing the amount of urine albumin by the amount of urine creatinine. Thymus is normal in less than 8% patients. Urine ACR reference range: Less than 3.0 mg/mmol. 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