Urine albumin/creatinine ratio (uACR): what your result means.

Albumin in urine relative to creatinine; an early marker of kidney damage. Urine albumin/creatinine ratio (uACR) is measured by urine test as part of the Organ panel in the HodieLabs Health Blueprint.

Why Urine albumin/creatinine ratio (uACR) matters

uACR is the gold standard for early kidney disease screening, more reliable than dipstick protein. uACR <3 mg/mmol is A1 (normal); 3–30 is A2 (moderately increased / microalbuminuria); >30 is A3 (severely increased / macroalbuminuria).

Associated risks when out of range: Early kidney/microvascular damage. Cardiovascular risk.

What the clinical evidence shows

The evidence base behind how the HodieLabs Evidence-Based Clinical Library interprets Urine albumin/creatinine ratio (uACR), from randomised trials, prospective cohorts and genetic (Mendelian randomisation) studies. Full citations in the reference list below.

• CKD Prognosis Consortium (The Lancet 2010): across 1.2+ million participants, albuminuria predicted all-cause and cardiovascular mortality independently of eGFR. Even 'high-normal' albumin leakage signalled vascular risk.
• KDIGO framework (2024): uACR forms one of the two axes of international kidney disease staging: an early, inexpensive window on both kidney and endothelial health.

Evidence-based reference ranges

The HodieLabs Evidence-Based Clinical Library interprets Urine albumin/creatinine ratio (uACR) against published clinical authority standards, never arbitrary "optimal" ranges. Measured in mg/mmol:

Clinical interpretation

• uACR is the gold standard for early kidney disease screening, more reliable than dipstick protein.
• uACR <3 mg/mmol is A1 (normal); 3–30 is A2 (moderately increased / microalbuminuria); >30 is A3 (severely increased / macroalbuminuria).
• Annual uACR screening is recommended for all adults with diabetes, hypertension, or cardiovascular disease.
• Incidental albuminuria should be confirmed on a subsequent first-morning specimen before clinical action.
• Confounders: exercise, acute febrile illness, urinary tract infection, menstruation, and sex-related differences in urinary creatinine excretion can all distort ACR interpretation.

What improves it: the evidence-based levers

• BP control
• Glycaemic control
• Clinical review if elevated

Recommended testing frequency: Annual, as part of a comprehensive panel. Single markers are always interpreted in context.

How Urine albumin/creatinine ratio (uACR) testing works at HodieLabs

Urine albumin/creatinine ratio (uACR) is measured in every Health Blueprint at our Melbourne Preventative Health & Longevity Clinic, interpreted by a doctor against the guideline-cited ranges above and tracked over time through your HodieLabs membership.

References

1. Chronic Kidney Disease Prognosis Consortium. Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in general population cohorts. Lancet. 2010;375:2073–2081.
2. KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int. 2024;105(4S):S117–S314.

This page is general information from the HodieLabs Evidence-Based Clinical Library, not medical advice. Speak with your GP about what testing and care is appropriate for you.