Preferred Sample Type
Suitable Specimen Types
- Plain Spot Urine
Sample Processing in Laboratory
Usual
Sample Preparation
Usual
Turnaround Time
1 DaySample Stability
4 ºC
Urine Protein:Creatinine ratio (Random urine)
General Information
Diabetes is a very common cause of kidney failure. Studies have shown that identifying diabetics in the very early stages of kidney disease by demonstrating an abnormal albumin:creatinine ratio (ACR) helps patients and doctors adjust treatment. With better diabetic control and better control of other complications, such as high blood pressure, the progression of diabetic kidney disease can be slowed down or prevented.
Albumin is the principal component of proteinuria in glomerular disease. Reagent strips in current clinical practice predominantly detect albumin, not total protein, but are not reliably quantitative. ACR has far greater sensitivity than protein:creatinine ratio (PCR) for the detection of low levels of proteinuria and enhances early identification of CKD. However, there may be clinical reasons for a specialist to subsequently use PCR to quantify and monitor significant levels of proteinuria.
To detect and identify proteinuria, use urine albumin:creatinine ratio (ACR) in preference, as it has greater sensitivity than PCR for low levels of proteinuria.
Patient Preparation
Early morning urine sample preferable
Notes
The urine protein:creatinine ratio is calculated as follows:
(Urine protein(g/L) X 1000)/Urine creatinine(mmol/L)
Please note, from 22/7/19 analysis performed using Abbott Alinity analyser. The test is awaiting UKAS accreditation.
Reference Range
- <15 mg/mmol Creatinine = Normal
- 15 – 49 mg/mmol Creatinine = Trace Proteinuria. Consider ACEI or ARB in diabetes.
- 50 – 99 mg/mmol Creatinine = Significant proteinuria. Repeat using early am sample. Consider ACEI or ARB in hypertension.
- 100 – 300 mg/mmol Creatinine = High proteinuria. If new finding, seek nephrology advice regardless of eGFR.
- >300 mg/mmol Creatinine = “Nephrotic range” proteinuria. If new finding, seek nephrology advice regardless of eGFR.
Source of Reference Range: NICE guideline CG73 (2008) and UK eCKD guidelines 2009.)