Microalbumin (urine albumin-to-creatinine ratio)
First-line screen for diabetic and hypertensive kidney damage. Detects albumin leaking through the glomerulus years before serum creatinine moves — the earliest treatable signal.
What it measures
Microalbumin is a small amount of albumin (the main blood protein) leaking into urine. A healthy glomerulus retains albumin almost completely; even tiny leakage signals glomerular injury. The test is reported as albumin-to-creatinine ratio (ACR) on a spot urine sample — ratio-normalization corrects for hydration, removing the need for 24-hour collection. ADA recommends annual microalbumin screening for every type-1 diabetic from year 5 of disease, every type-2 diabetic from diagnosis, and every hypertensive adult.
What a high value can mean
- Diabetic nephropathy (early) — most common cause; ACR 30–300 = microalbuminuria.
- Hypertensive nephrosclerosis — chronic uncontrolled BP damages glomeruli.
- Chronic kidney disease — any cause; macroalbuminuria >300 marks established damage.
- Pre-eclampsia in pregnancy — high BP + new proteinuria after 20 weeks.
- Transient causes — strenuous exercise, fever, UTI, dehydration. Repeat in 1–3 months before diagnosing.
What a low value can mean
- Generally favourable; intact glomerular barrier.
When to discuss with a doctor
Persistent ACR >30 mg/g on two of three samples 3 months apart is the diagnostic threshold for microalbuminuria. The treatment lever is tight glucose + blood-pressure control plus an ACE inhibitor or ARB, which reduces glomerular pressure and slows progression by ~50%. Mediora.AI flags the value against the ADA threshold; the kidney work-up belongs with endocrinology + nephrology.