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Urinary albumin (typically reported as albumin-to-creatinine ratio, ACR) detects tiny amounts of albumin leaking into the urine — a sign that kidney filtering membranes are becoming damaged and protein is escaping into the urine when it should be retained. Microalbuminuria is one of the earliest detectable signs of kidney damage in diabetes and hypertension — appearing years before eGFR starts to fall — and is a strong independent predictor of cardiovascular events. Catching microalbuminuria early enables interventions (blood pressure control, SGLT2 inhibitors, renin-angiotensin blockade) that can halt or reverse progression.
Also known as: Albumin (Urine), MA, Malb, Micro albumin, Microalbumin, Microalbuminuria, Urine Albumin
Elevated urine albumin is the earliest sign of diabetic nephropathy and hypertensive kidney damage. 30-300 mg/L defines microalbuminuria. Low or absent is desirable.
Optimal is below 20 mg/L. Any persistent albumin detection signals the need to optimize blood pressure and glycemic control.