Interpretation of Urine Albumin and Albumin-Creatinine Ratio Results
The decreased urine albumin level (6 mg/L) and albumin-creatinine ratio (0.5 mg/mmol) with increased creatinine (13.2 mmol/L) indicates normal kidney function with appropriate concentration of urine, which is a positive finding reflecting absence of kidney damage.
Understanding the Values
Albumin and ACR Classification
- Your albumin level of 6 mg/L and ACR of 0.5 mg/mmol fall within category A1 (normal to mildly increased albuminuria) 1
- Normal values according to KDIGO guidelines:
- ACR < 3 mg/mmol (< 30 mg/g)
- Albumin < 30 mg/L
- Your values are well below these thresholds 1
Creatinine in Urine
- Increased urine creatinine (13.2 mmol/L) suggests:
Clinical Significance
Positive Indicators
- Low ACR (0.5 mg/mmol) indicates absence of kidney damage 1
- The combination of low albumin with high creatinine in urine is favorable, as it suggests:
- Intact glomerular filtration barrier (preventing albumin leakage)
- Good muscle mass and metabolism (source of creatinine)
- Appropriate kidney concentrating ability 2
Risk Assessment
- According to KDIGO heatmap, your values place you in the lowest risk category for CKD progression and cardiovascular events 1
- With ACR < 3 mg/mmol and assuming normal GFR, you would be in the green (very low risk) zone 1
Factors Affecting Interpretation
Biological Variability
- Urine albumin and ACR can vary by up to 48.8% between measurements 3
- For accurate assessment, multiple measurements over time are ideal
- Factors that can temporarily increase albumin excretion include:
- Exercise within 24 hours before collection
- Urinary tract infections
- Fever
- Heart failure
- Marked hyperglycemia
- Hypertension 1
Urine Concentration Effects
- High urine creatinine can result in lower ACR values for the same amount of albumin 4, 5
- The increased creatinine in your sample (13.2 mmol/L) helps explain the very low ACR despite the already low albumin 6
Monitoring Recommendations
Follow-up Testing
- For individuals with normal ACR:
Additional Assessment
- Serum creatinine with eGFR should be checked at least annually regardless of ACR status 1, 2
- This provides a complete picture of kidney function, as some individuals can have decreased GFR without albuminuria 1
Conclusion
Your urine test results show normal albumin levels and ACR with appropriately concentrated urine (high creatinine), indicating healthy kidney function with intact filtration barriers. These values place you in the lowest risk category for kidney disease progression according to current guidelines.