What is a normal urine ACR?

A urine ACR below 30 mg/g (or below 3 mg/mmol) is considered normal or A1 range. Values of 30–300 mg/g are moderately increased (A2) and values above 300 mg/g are severely increased (A3).

What does a high urine ACR mean?

A high urine ACR means more albumin than expected is leaking into the urine. This can be an early sign of kidney damage, particularly in people with diabetes or high blood pressure. Repeat testing is usually needed to confirm persistence.

Urine ACR Report Reader | Albumin Creatinine Ratio Explained

Enter Your Urine ACR Result

ACR may be written as urine ACR, uACR or albumin-to-creatinine ratio. Enter the number and select the correct unit.

ℹ️ ACR may be written as urine ACR, uACR or albumin-to-creatinine ratio on your report. Enter the number and select the correct unit (mg/g or mg/mmol).

Urine ACR value

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Was this test done during fever, dehydration, vomiting, diarrhoea, severe infection, hospital admission, pregnancy, or soon after a contrast CT scan?

⚠️ This result may be affected by a temporary or acute condition. Please interpret it with medical advice.

Entered Values

Urine ACR Interpretation

🔄 Repeat Testing Note

An isolated elevated ACR can sometimes be caused by temporary factors. Repeat testing is commonly used to confirm persistence, especially if this is the first abnormal result.

⚠️ Acute Condition Note

This result may be affected by a temporary or acute condition. Please interpret it with medical advice.

ℹ️ Important

This tool provides educational information only. It does not diagnose kidney disease and does not replace medical advice.

This tool provides educational interpretation only. Always consult your doctor for personalised medical guidance.

Understanding Your Urine ACR Result

Urine ACR (albumin-to-creatinine ratio) is one of the most important tests for detecting early kidney damage. It measures the amount of albumin in your urine relative to creatinine, making the result reliable regardless of how concentrated or dilute the urine sample is.

What Is Albumin in Urine?

Albumin is a protein that is normally kept inside the blood vessels by the kidney's filtering units (glomeruli). When the kidneys are damaged, albumin leaks into the urine. Even a small amount of albumin in the urine (microalbuminuria) can indicate early kidney damage, particularly in people with diabetes or high blood pressure.

Urine ACR Categories

ACR (mg/g)	ACR (mg/mmol)	Category	Meaning
Below 30	Below 3	A1 — Normal to Mildly Increased	Albumin in urine is in the normal or near-normal range.
30 – 300	3 – 30	A2 — Moderately Increased	May suggest early kidney damage. Common in diabetes and high blood pressure.
Above 300	Above 30	A3 — Severely Increased	Significantly elevated albumin. Medical review recommended.

Why Is ACR Better Than a Simple Urine Albumin Test?

A simple urine albumin measurement can vary depending on how much fluid you have drunk or how concentrated the urine sample is. By measuring albumin relative to creatinine — another waste product excreted at a fairly constant rate — the ACR corrects for urine concentration and gives a more reliable result.

ACR and eGFR Together

ACR and eGFR provide complementary information. A high ACR can indicate kidney damage even when eGFR is still above 60 — this is important because it means kidney damage can be detected early, before filtration has started to fall. Using both tests together is recommended by KDIGO guidelines for a complete kidney risk assessment.

What Can Temporarily Raise ACR?

ACR can be transiently elevated by fever, intense exercise, urinary tract infection, dehydration, acute illness, pregnancy, and soon after a contrast CT scan. This is why a single elevated ACR result is usually confirmed with a repeat test before a clinical diagnosis is made.

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Frequently Asked Questions About Urine ACR

Common questions about urine albumin-to-creatinine ratio testing — answered by Sineth Hospitals.

Can one abnormal ACR result diagnose chronic kidney disease?▼

No. CKD is usually diagnosed only when kidney abnormalities persist for at least 3 months. A single elevated ACR result needs to be confirmed with repeat testing. Your doctor will guide you on the appropriate follow-up interval.

Can eGFR be normal but urine albumin abnormal?▼

Yes. Albumin in urine can be an early sign of kidney damage even when eGFR is above 60. This is especially common in diabetes and high blood pressure, where kidney damage begins in the filtering units before the overall filtration rate falls. This is why testing both eGFR and urine ACR is recommended.

Which is more useful: urine albumin or ACR?▼

ACR is usually more useful because it adjusts albumin for urine concentration. A simple urine albumin test can vary depending on how concentrated the sample is at the time of collection. ACR is more consistent and is the preferred test in clinical guidelines for detecting kidney damage.

Should I repeat an abnormal ACR?▼

Often yes. Repeat testing is commonly used to confirm that albuminuria is persistent, especially if this is the first abnormal result. Temporary factors — such as fever, dehydration, heavy exercise, or urinary tract infection — can cause a transient elevation. A repeat test helps confirm whether the raised ACR reflects ongoing kidney damage.