What is ACR test?
The ACR test is an urine test that measures the amount of albumin in the urine. Random urine is collected to measure both albumin and creatinine. Then ACR is calculated as albumin to creatinine ratio.
Why perform ACR test?
Albumin is normally found in the blood and filtered by the kidneys. When the kidneys are working as they should, there may be a very small amount of albumin in the urine. But when the kidneys are damaged, abnormal amounts of albumin leak into the urine. When the kidneys spill albumin, it can mean serious kidney damage is present. This can lead to chronic kidney disease. The creatinine level in the blood will rise due to poor clearance of creatinine by the kidneys. Abnormally high levels of creatinine thus warn of possible malfunction or failure of the kidneys. Thus, the urinary albumin and creatinine ratio is important for the diagnosis of chronic kidney disease.
Understanding your results by CKD* categories
||Normal to mild increased
*CKD: Chronic kidney disease
ACR Testing Guideline
||Begin screening 5 years after diagnosis, then annually
||Begin screening at diagnosis, then annually
Reference: American Diabetes Association
Who should perform ACR test?
According to the Centers for Disease Control and Prevention (CDC), diabetes and high blood pressure are the major causes of chronic kidney disease (CKD). The CDC recommends regular testing for CKD in people who have diabetes, high blood pressure, and/or other risk factors, such as heart disease, family history of CKD, obesity, previous damage to the kidneys, and older age. The albumin/creatinine ratio is an important part of this assessment.*
*Centers for Disease Control and Prevention. Chronic kidney disease in the United States, 2019. https://www.cdc.gov/kidneydisease/publications-resources/2019-national-facts.html. Last reviewed March 11, 2019. Accessed February 4, 2020.
How often perform ACR test?
The American Diabetes Association (ADA) recommends performing an annual test to assess urine albumin excretion in type 1 diabetic patients with diabetes duration of 5 years and in all type 2 diabetic patients, starting at diagnosis.