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PTD - 265

Test Directory - Urine Albumin/Creatinine Ratio (Microalbuminuria)

Clinical Indications

This test is recommended in diabetes mellitus and Chronic Kidney Disease (CKD) stage 3A and above to identify early stage renal disease so progression can be slowed by appropriate therapy. It should be measured on diagnosis and, if normal, repeated annually.
At this time, point of care testing for small traces of albumin (microalbumin) is considered unreliable and all positive results must be confirmed by laboratory testing. It is recommended that point of care tests are not used.

Test Includes

Urine albumin, urine creatinine and urine albumin:creatinine ratio. Urine total protein is also measured to check for very high levels that may give false negative urine albumin results due to antigen excess in the analysis. Urine protein:creatinine ratio is also reported.

Request Form

Combined Pathology Blood form (Yellow/Black)


On request

Specific Criteria

Detection of microalbuminuria in patients with diabetes (types I and II). 

Patient Preparation

Patients should avoid strenuous exercise or sexual activity for a 2 days prior to collecting the urine. Samples should not be collected when there are symptoms of UTI or thrush.

Turnaround Time

2 days


Early Morning Urine.


2 ml


White Capped Universal

Causes for Rejection

Unlabelled samples.


Results are reported as a albumin:creatinine ratio to correct for urine concentration. Cut-off limits are different depending on whether patient has diabetes and/or CKD. An abnormal result in a patient with diabetes is a albumin:creatinine ratio of greater than 2.5 (males) or 3.5 (females). If abnormal please follow the albuminuria testing protocol. For patients with CKD an abnornal ratio is greater than 10.0.

Lab. Handling

Processing: Test code ACR. Aliquot into AU tube with a urine barcode. Centrifuge the aliquot then run on Cobas line.
Primary sample and aliquot stored at
4C in the cold room (CB23) after analysis.

Version 1.0 / May 2014                                                                                                           Approved by: Consultant Biochemist